GAMMA: A genetic-clinical prognostic model for risk stratification in patients with relapsed/refractory acute myeloid leukemia receiving allogeneic hematopoietic stem cell transplantation
In brief
A relapsed AML transplant model reaches 0.79 AUC for 1-year survival
The model combines disease status, patient and donor age, and genetic findings to sort transplant recipients into four risk groups. It distinguished survival in 297 patients from 11 external centers, with a 3-year area under the curve of 0.786; in a prospective group of just 54 patients, its 1-year value was 0.79. Larger prospective studies are needed to show whether using the score improves care.
- Journal
- Cancer letters (Q1)
- Published
- 8 October 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Yue Jin, Zhuo-Yu An, Peng Zhao, Hai-Xia Fu, Ying Lu, Dingming Wan, et al.
- PMID
- 42849654
- DOI
- 10.1016/j.canlet.2026.218883
Why clinicians should know about it
- Picked for Hematology (paper of the day, 12 October 2026): Genetic‑clinical model for R/R AML allo‑HSCT
Abstract
The prognosis of patients diagnosed with relapsed/refractory acute myeloid leukemia (R/R AML) remains poor, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative strategy. An integrated model incorporating both genetic and clinical features to inform clinical decision-making in the HSCT setting for R/R AML patients is still lacking. In the current study, 301 R/R AML patients who underwent allo-HSCT at Peking University People's Hospital from 2018 to 2023 were included in the derivation group. A total of 297 R/R AML patients from 11 other HSCT centers in China were included in the external validation group. A total of 54 R/R AML patients who underwent allo-HSCT at Peking University People's Hospital in 2025 were assembled as a prospective validation cohort. A comprehensive prognostic model combining clinical factors and genetic abnormalities, including disease status before HSCT, patient and donor age, FLT3-ITD, TP53 mutation, KMT2A rearrangement (KMT2Ar) and complex karyotypes, for R/R AML patients treated with allo-HSCT was developed. Patients were stratified into four risk groups: low-risk, intermediate-low-risk, intermediate-high-risk, and high-risk. In the internal validation cohort, the 1-, 2- and 3-year time-dependent area under the curve (AUC) values of overall survival (OS) were 0.768, 0.795 and 0.799, respectively. In the external validation cohort, the 1-, 2- and 3-year time-dependent AUC values of OS were 0.676, 0.729 and 0.786, respectively. The 1-year AUC of the prospective validation cohort reached 0.79. This model could refine risk stratification in R/R AML patients undergoing allo-HSCT, and potentially inform combination therapy strategies and post-transplantation monitoring.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.