Highlights from

ASH 2020

62nd Annual Meeting & Exposition of the American Society of Hematology

Virtual 5 - 8 December 2020

Acute Myeloid Leukaemia-Composite Model successfully predicts both early and late mortality

Researchers in Canada tested the Acute Myeloid Leukaemia–Composite Model (AML-CM) and found that it accurately predicted 1-year mortality in patients with newly diagnosed AML [1]. They speculate that the model can be further used to both mitigate the risk of, and adjust for, comorbidities during treatment.

In 2017, Sorror et al. published an original investigational article detailing their development of a model that could be used to test and validate the impact of comorbidities on 1-year mortality in patients with AML [2]. Dr Shannon Murphy (Dalhousie University, Canada) shared the results of her team’s efforts to validate this tool at the ASH 2020. The AML-CM incorporates both comorbidities and leukaemia-specific features to predict overall mortality following administration of intensive induction chemotherapy. It consists of 3 parts: the haematopoietic cell transplantation–comorbidity index (HCT-CI), age, and cytogenetic molecular risks (as per European LeukemiaNet 2017 guidelines).

Dr Murphy’s team retrospectively collected data on 194 patients with newly diagnosed AML who were beginning induction chemotherapy, and calculated their AML-CM scores. According to the European LeukemiaNet classification scheme, 23% of the patients fell into the favourable-risk category, 37% into the intermediate-risk category, 34% into the high-risk category, and 6% were unknown. Both 8-week and 1-year mortality were analysed using logistic regression models, and overall survival was modelled using the Fine and Grey model.

The AML-CM was a valid prognosticator for both early (8-week) and late (1-year) mortality. Overall survival was inversely proportional to increasing AML-CM scores. Dr Murphy asserts that these results underline the fact that it is imperative to assess comorbidities before initiating induction therapy for AML. She speculates that targeted interventions could be tailored to mitigate the risks of the comorbidities alongside leukaemia treatment. Furthermore, she proposes that the AML-CM could be used to adjust for the impact of comorbidities in trials evaluating new therapies for AML.

  1. Murphy S, et al. The Prognostic Validity of the Acute Myeloid Leukemia Composite Model in Predicting Risks of One-Year Mortality Among Patients in Atlantic Canada: A Multi-Centre Experience. 62nd ASH Annual Meeting, December 5-8, 2020. Abstract 999.

  2. Sorror M, et al. JAMA Oncol 2017;3(12):1675-1682.

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