Risk Prognostication After Hypomethylating Agent Plus Venetoclax Therapy

The PRISM prognostic model, built on data from 2,092 adults with newly diagnosed acute myeloid leukaemia treated with a hypomethylating agent plus venetoclax, separates patients into three groups with clearly different outcomes: median overall survival was 25.1-28.8 months in the low-risk group, 12.5-14.7 months in the moderate-risk group and 5.8-6.7 months in the high-risk group (p < 0.001). The model combines 17 clinical and genomic variables and was tested in two independent external cohorts (n = 500 and n = 222). Compared with the existing 4-gene classifier, PRISM reassigned about 40% of patients to a different risk group, including more than half of those previously classed as favourable risk, and discriminated better (C-index 0.63-0.65 versus 0.59-0.61; p < 0.05).