Table 2.
Patients Characteristics According to Lindsley’s Modified Genetic Classifier.
| Lindsley’s Modified Genetic Classifier | Total | P | |||
|---|---|---|---|---|---|
| TP53/PPM1D | MDS-like | De novo-like | |||
| First cancer, n (%) | 0.002 | ||||
| Breast cancer | 13 (46%) | 15 (79%) | 26 (87%) | 54 (70%) | |
| Gynecological cancer | 15 (54%) | 4 (21%) | 4 (13%) | 23 (30%) | |
| First cancer treatment, n (%) | 0.1 | ||||
| Chemotherapy/radiotherapy | 16 (57%) | 14 (74%) | 22 (73%) | 52 (68%) | |
| Radiotherapy alone | 2 (7%) | 3 (16%) | 5 (17%) | 10 (13%) | |
| Chemotherapy alone | 10 (36%) | 2 (11%) | 3 (10%) | 15 (19%) | |
| Median treatment lines, Moy (std) | 2.79 (2.22) | 1.84 (1.61) | 1.63 (1.03) | 2.1 (1.74) | 0.05a |
| Alkylating agent, n (%) | 23 (82%) | 15 (79%) | 25 (83%) | 63 (82%) | 0.9 |
| Anthracycline, n (%) | 11 (39%) | 14 (74%) | 24 (80%) | 49 (64%) | 0.003 |
| Median time between TRMN and cancer, y (95% CI) | 6.15 (5–10.3) | 4.4 (3.3–14.4) | 4.3 (2.7–8.4) | 5.1 (3.6–6.6) | 0.4b |
| Median age at TRMN, y (IQR) | 65.5 (56.5–74) | 68 (61.5–76.5) | 56 (50.25–64) | 62 (54–70) | 0.004a |
| Performance status, n (%) | 0.1 | ||||
| 0–1 | 17 (60%) | 16 (84%) | 23 (77%) | 56 (73%) | |
| 2–3 | 11 (39%) | 3 (16%) | 7 (23%) | 21 (27%) | |
| Myeloid neoplasm, n (%) | <0.0001 | ||||
| AML | 13 (46%) | 6 (32%) | 30 (100%) | 49 (64%) | |
| MDS | 15 (54%) | 13 (68%) | 0 (0%) | 28 (36%) | |
| Cytogenetic failure, n (%) | 3 (11%) | 1 (5%) | 0 (0%) | 4 (5%) | 0.1c |
| Normal karyotype, n (%) | 0 (0%) | 11 (61%) | 4 (13%) | 15 (20%) | <0.0001 |
| Balanced translocation, n (%) | 1 (4%) | 0 (0%) | 18 (60%) | 19 (26%) | <0.0001 |
| Complex karyotype, n (%) | 21 (84%) | 3 (17%) | 1 (3%) | 25 (34%) | <0.0001 |
| Gene mutations, median (SD) | 8 (29%) | 12 (63%) | 12 (40%) | 32 (42%) | 0.06 |
| ELN 2017 AML Ccssification, n (%) | <0.0001 | ||||
| Adverse | 13 (100%) | 2 (33%) | 6 (20%) | 21 (43%) | |
| Favorable | 0 (0%) | 1 (17%) | 14 (47%) | 15 (31%) | |
| Intermediate | 0 (0%) | 3 (50%) | 10 (33%) | 13 (27%) | |
| MDS IPSS score, n (%) | 0.03 | ||||
| Low/Int1 | 0 (0%) | 4 (30%) | 0 (0%) | 4 (14%) | |
| Int2/High | 15 (100%) | 9 (69%) | 0 (0%) | 24 (86%) | |
| TRMN treatment, n (%) | <0.0001 | ||||
| Intensive | 6 (21%) | 3 (16%) | 25 (83%) | 34 (44%) | |
| Low dose | 13 (46%) | 10 (53%) | 4 (13%) | 27 (35%) | |
| BSC | 9 (32%) | 6 (32%) | 1 (3%) | 16 (21%) | |
| CR rate, n (%) | 10 (36%) | 7 (37%) | 25 (83%) | 42 (55%) | 0.0003 |
| HSCT, n (%) | 5 (18%) | 2 (11%) | 9 (30%) | 16 (21%) | 0.2 |
| Median OS, mo (95% CI) | 7.5 (3.5–15.4) | 14.5(7.5–41.5) | 25.2 (13.3–NR) | 13.9 (10.5–20.4) | <0.0001b |
| Median EFS, mo (95% CI) | 6.2 (3.5–13.2) | 10.6 (7.5–41.5) | 18.4 (7.1–NR) | 10.1 (6.8–16.3) | 0.004b |
aWilcoxon test.
bLogrank test.
cPearson's Chi-square test.
AML = acute myeloid leukemia; BSC = best supportive care; CHIP-AM = CHIP-associated mutations; CI = confidence interval; CR = complete remission; EFS = event-free survival; HSCT = hematopoietic stem cell transplantation; IQR = intervalle quartile range; MDS = myelodysplastic syndrome; NR = not reached; OS = overall survival; TRMN = therapy-related myeloid neoplasm.