The prognostic value of cloned genetic mutations detected by second-generation sequencing in RUNX1-RUNX1T1 positive acute myeloid leukemia patients receiving intensive consolidation therapy.
10.3760/cma.j.issn.0253-2727.2020.03.005
- Author:
Jing Qiu YU
1
;
Sheng Li XUE
1
;
Zheng LI
1
;
Jun WANG
1
;
Chao WANG
1
;
Xiao Ling CHU
1
;
Rong HAN
1
;
Tao TAO
1
;
Qiao Cheng QIU
1
;
De Pei WU
1
Author Information
1. Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
- Publication Type:Journal Article
- Keywords:
Genetic mutations;
Leukemia, myeloid, acute;
RUNX1-RUNX1T1 fusion gene;
Second-generation sequencing
- MeSH:
Consolidation Chemotherapy;
Core Binding Factor Alpha 2 Subunit/genetics*;
Humans;
Leukemia, Myeloid, Acute/genetics*;
Mutation;
Prognosis;
RUNX1 Translocation Partner 1 Protein/genetics*;
Retrospective Studies;
fms-Like Tyrosine Kinase 3
- From:
Chinese Journal of Hematology
2020;41(3):210-215
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the prognostic value of clonal gene mutations detected by second-generation sequencing in patients with positive RUNX1-RUNX1T1 acute myeloid leukemia (AML) who received high-dose chemotherapy or autologous transplantation (intensive consolidation therapy) in the first complete remission (CR(1)) state. Methods: 79 AML patients with positive RUNX1-RUNX1T1 who received intensive consolidation therapy in CR(1) state from July 2011 to August 2017 were analyzed retrospectively. Kaplan-Meier curve and Cox regression model were used to figure out the effect of leukocyte counts at onset and gene mutations for prognosis. Results: C-KIT, FLT3, CEBPA and DNMT3A gene mutations were found in 25 (31.6%) , 6 (7.6%) , 7 (8.9%) and 1 (1.3%) patient among the population. Mutations in C-KIT exon17 and C-KIT exon8 were detected in 19 (24.1%) and 5 (6.3%) cases, respectively, and mutations of FLT3-ITD were confirmed in 5 (6.3%) cases. The higher leukocyte counts presented at onset of leukemia, the shorter overall survival (OS) was seen in these patients (P=0.03) . Patients with C-KIT exon17 mutation had significantly shorter OS (P=0.01) and disease free survival (DFS) (P=0.006) compared with those without gene mutations, and patients with FLT3-ITD gene mutation got the inferior OS (P=0.048) and DFS (P=0.071) . Conclusion: In AML patients with positive RUNX1-RUNX1T1 receiving intensive consolidation therapy, the white blood cell counts at onset of leukemia, C-KIT mutations in exon 17, and FLT3-ITD gene mutations suggest poor prognosis, which would contribute to elaborate risk stratification, personalized treatment and predict prognosis for these patients.
