Resistance prediction in AML: analysis of 4601 patients from MRC/NCRI, HOVON/SAKK, SWOG and MD Anderson Cancer Center

Therapeutic resistance remains the principal problem in acute myeloid leukemia (AML). We used area under receiver-operating characteristic curves (AUCs) to quantify our ability to predict therapeutic resistance in individual patients, where AUC=1.0 denotes perfect prediction and AUC=0.5 denotes a coin flip, using data from 4601 patients with newly diagnosed AML given induction therapy with 3+7 or more intense standard regimens in UK Medical Research Council/National Cancer Research Institute, Dutch–Belgian Cooperative Trial Group for Hematology/Oncology/Swiss Group for Clinical Cancer Research, US cooperative group SWOG and MD Anderson Cancer Center studies. Age, performance status, white blood cell count, secondary disease, cytogenetic risk and FLT3-ITD/NPM1 mutation status were each independently associated with failure to achieve complete remission despite no early death (‘primary refractoriness’). However, the AUC of a bootstrap-corrected multivariable model predicting this outcome was only 0.78, indicating only fair predictive ability. Removal of FLT3-ITD and NPM1 information only slightly decreased the AUC (0.76). Prediction of resistance, defined as primary refractoriness or short relapse-free survival, was even more difficult. Our limited ability to forecast resistance based on routinely available pretreatment covariates provides a rationale for continued randomization between standard and new therapies and supports further examination of genetic and posttreatment data to optimize resistance prediction in AML.

Methane generation from human, animal, and agricultural wastes : report of an ad hoc panel of the Advisory Committee on Technology Innovation, Board on Science and Technology for International Development, Commission on International Relations, National Research Council.

Mode of access: Internet.

Joint Meeting of the U.S. Sections of the Combustion Institute, Western states, Central states, Eastern states : [proceedings].

Mode of access: Internet.

American National Standard N432 : radiological safety for the design and construction of apparatus for gamma radiography /

"Approved August 15, 1980."

American National Standard N43.10 : safe design and use of panoramic, wet source storage gamma irradiators (category IV).

Item 245.

National defense into the 21st century : defining the issues /

"A special report from the Strategic Studies Institute."

Measurement of value of recorded scientific information; final report to Office of Science Information Service, National Science Foundation.

"AD-260 734."

Readings in documentary editing : a highly selective list compiled for the NHPRC Institute for the Editing of Historical Documents /

Shipping list no.: 95-0210-P.

American national standard for information sciences : extended latin alphabet coded character set for bibliographic use /

"ANSI Z39.47-1985."

Proceedings of 1st Ad-Hoc Forum of Scientific and Technical Information Analysis Center Managers, Directors, and Professional Analysts, held at Battelle Memorial Institute, Columbus, Ohio, November 9-11, 1965 /

"Conf-651131, General, miscellaneous, and progress reports (TID-4500)."

Proceedings of the Japan-U.S. Seminar on HTGR Safety Technology, September 15-16, 1977, Brookhaven National Laboratory, Upton, N. Y. /

"NUREG/CR-0358, BNL-NUREG-50689, NRC-8"

Department of State and U.S. Information Agency : accompanying report of the National Performance Review /

Mode of access: Internet.

Annual report - National Academy of Sciences.

Vols. for include reports for the National Research Council; 1965/66- include reports for the National Academy of Engineering; 1971/72- include reports for the Institute of Medicine.

American National Standard N433.1 : safe design and use of self-contained, dry source storage gamma irradiators (category I).

Issued July 1978.

American National Standard N537 : radiological safety standard for the design of radiographic and fluoroscopic industrial x-ray equipment /

"ANSI N537-1976."