What are the low, intermediate, and high-risk criteria for acute myeloid leukemia?
May 05, 2023
Source: Cainiu Health
Dr. Zhang Heyang
Introduction
The risk stratification for acute myeloid leukemia is based on factors such as patient age, white blood cell count, cytological classification, and genetic abnormalities, dividing patients into three groups: low-risk, intermediate-risk, and high-risk. It should be noted that risk stratification only estimates prognosis and does not solely determine the treatment plan. The specific treatment strategy for each patient must be decided by considering multiple factors comprehensively.
Acute myeloid leukemia (AML) is clinically categorized into low-risk, intermediate-risk, and high-risk groups based on risk stratification. The specific classification is as follows:
1. Low-risk
Patients are relatively young, under 60 years of age. White blood cell count is low, less than 10×10^9/L. Cytologically classified as subtype M1 or M2, with a higher proportion of myeloblasts and immature granulocytes in the bone marrow, and no significant genetic abnormalities.
2. Intermediate-risk
Patients are older, aged between 60 and 69 years. White blood cell count is elevated, ranging from 10 to 100×10^9/L. Cytologically classified as subtype M0, M4, or M5, with a lower proportion of myeloblasts and immature granulocytes in the bone marrow. Certain genetic abnormalities are present, such as nucleophosmin (NPM1) gene mutations or CEBPA gene mutations.
3. High-risk
Patients are older, aged 70 years or above. White blood cell count is markedly elevated, exceeding 100×10^9/L. Cytologically classified as subtype M6 or M7, with a higher proportion of immature erythroid or megakaryocytic cells in the bone marrow. Complex genetic abnormalities are present, such as TP53 gene alterations, FLT3-ITD gene mutations, or chromosomal deletions such as 7q or 5q.
It should be noted that risk stratification in acute myeloid leukemia serves only as an estimate of patient prognosis and is not the sole determinant for treatment selection.
