Prognosis and Application of Day 14 Bone Marrow Results in Acute Myeloid Leukemia Induction
Bibliographic record
Abstract
Abstract Introduction: The 2017 National Comprehensive Cancer Network (NCCN) guidelines for Acute Myeloid Leukemia (AML) recommend performing a bone marrow aspirate (BMA) and trephine biopsy (BMTB) 14-21 days after starting induction therapy (commonly referred to as a “Day 14 [D14] marrow”). Those who do not achieve a hypoplastic marrow, with cellularity Methods: Patients with AML aged 18-70 years undergoing induction therapy with standard “7+3” regimens at Vancouver General Hospital or University of Alberta Hospital from 2007-2015 and 2005-2015 respectively were included. D14 cellularity was determined on BMTB and blast percentage (blast %) was assessed by morphology on BMA and BMTB. We examined outcomes by three D14 risk categories: 1. blast % ( Results: 546 patients were identified with 486 (89.0%) undergoing a D14 BM (Table 1). On the D14 BM, 190 patients had blasts ≥5%, 96 had cellularity ≥20% (with 12 patients also having blasts In univariate analysis, D14 low-risk categories were associated with higher CR/CRi rates (D14 blasts 131 patients (27%) underwent a second IC, most commonly with etoposide/cyclophosphamide (n=48) or mitoxantrone/etoposide (n=48) regimens based upon the results of the D14 BM. CR/CRi rates for patients receiving 1 vs. 2 ICs in high risk D14 groups were: 43% vs. 62%, p=0.01 (D14 blasts ≥ 5%), 67% vs. 55%, p=0.33 (D14 cellularity >20%) and 38% vs. 55%, p=0.35 (D14 blasts ≥5% and cellularity ≥20%). In patients with ≥5% residual blasts on D14 marrow but Conclusion: D14 BM results are prognostic for achievement of CR/CRi following induction therapy for AML. D14 blasts Download : Download high-res image (227KB) Download : Download full-size image Disclosures Hogge: Novartis, Roche, and Sanofi: Consultancy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".