欧洲白血病网根据同年发布的两个新的髓系分类，于 2022 年完善了急性髓系白血病 (AML) 的风险分类 (ELN 2022)。我们回顾性评估了 ELN 2022 对 120 名接受同种异体造血细胞移植 (allo-HCT) 的 AML 患者的预后价值，其中包括 2011 年至 2021 年在我们中心首次完全缓解 (CR1) 的 99 名患者。不良风险患者 (Adv) 在总生存期 (OS) 和无白血病生存期 (LFS) 方面表现较差（OS [p = 0.003]、LFS [p = 0.02]），经多变量分析证实（风险比 [HR]） ] 对于 OS = 2.00，p = 0.037）。这些结果也出现在 CR1 异体移植患者中。进一，LFS 的 HR：3.36，p< 0.001），2 年累积复发率较高（p< 0.001）。值得注意的是，在该分析中，高级患者和中间患者的结果相似。这些发现强调了 ELN 2022 对接受异基因 HCT 的患者的预后价值，可以通过识别 Adv 风险组内的不良遗传子集 (AdvP) 来改善预后。© 2024 英国血液学会和 John Wiley

European LeukemiaNet refined their risk classification of acute myeloid leukaemia (AML) in 2022 (ELN 2022) according to the two new myeloid classifications published the same year. We have retrospectively assessed the prognostic value of the ELN 2022 in 120 AML patients undergoing allogeneic haematopoietic cell transplantation (allo-HCT), including 99 in first complete response (CR1) from 2011 to 2021 in our centre. Adverse risk patients (Adv) presented inferior outcome in terms of overall survival (OS) and leukaemia-free survival (LFS) (OS [p = 0.003], LFS [p = 0.02]), confirmed in multivariate analysis (hazard ratio [HR] for OS = 2.00, p = 0.037). These results were also seen in patients allografted in CR1. Further analysis identified a subgroup named adverse-plus (AdvP), including complex karyotype, MECOM(EVI1) rearrangements and TP53 mutations, with worse outcomes than the rest of groups of patients, including the Adv (HR for OS: 3.14, p < 0.001, HR for LFS: 3.36, p < 0.001), with higher 2-year cumulative incidence of relapse (p < 0.001). Notably, within this analysis, the outcome of Adv and intermediate patients were similar. These findings highlight the prognostic value of ELN 2022 in patients undergoing allo-HCT, which can be improved by the recognition of a poor genetic subset (AdvP) within the Adv risk group.© 2024 British Society for Haematology and John Wiley & Sons Ltd.