Hiệu quả điều trị bệnh bạch cầu cấp dòng tủy ở người lớn theo phân nhóm nguy cơ ELN 2017

Acute Myeloid Leukemia (AML) remains a complex and often fatal hematologic malignancy, characterized by its diverse genetic and biological features. Effective management hinges on precise risk stratification, with the 2017 European LeukemiaNet (ELN) classification emerging as a vital tool for guiding treatment decisions and predicting patient prognosis. Despite advancements in molecular diagnostics in Vietnam, there is a paucity of local studies evaluating the practical utility and impact of the ELN 2017 system on treatment outcomes. This study aims to address this gap by describing the clinical and biological characteristics of adult AML patients, categorized by the 2017 ELN risk groups, and assessing treatment efficacy across these distinct stratification profiles.

Hematologists, oncologists, medical researchers, and clinicians involved in the diagnosis and treatment of Acute Myeloid Leukemia.

This retrospective study aimed to evaluate treatment outcomes for adult Acute Myeloid Leukemia (AML) patients in Vietnam, stratifying them according to the 2017 European LeukemiaNet (ELN) risk classification. Analyzing data from 103 patients treated at the Blood Transfusion and Hematology Hospital between January 2020 and October 2023, the research categorized individuals into favorable (23.3%), intermediate (45.63%), and adverse (31.07%) risk groups based on ELN 2017 criteria. Key outcomes assessed included complete remission (CR), measurable residual disease (MRD), overall survival (OS), and disease-free survival (DFS). The findings revealed an overall CR rate of 69.91% and MRD negativity in 22.23% of patients. Crucially, CR, OS, and DFS rates were significantly lower in the adverse risk group compared to the favorable and intermediate groups (p < 0.05 for CR, OS, and DFS), underscoring the prognostic power of the ELN classification. Specifically, the median overall survival was 30.8 months and disease-free survival was 27 months, with clear distinctions across risk categories, demonstrating that the ELN system is a robust tool for predicting patient prognosis and guiding treatment choices. The study concludes that the ELN 2017 classification holds significant clinical utility for risk stratification and tailoring post-induction therapeutic strategies in AML patients. It is recommended that this classification be routinely applied in clinical practice. For patients in intermediate and adverse risk groups, allogeneic stem cell transplantation should be considered for improved prognosis, and further research is warranted on post-transplant maintenance therapies. Future studies should aim for larger, multi-center cohorts and extended follow-up periods to validate these findings and explore additional treatment optimization strategies.