Analysis of Gene Mutation Characteristics and Prognosis of Elderly Patients with Acute Myeloid Leukemia.
10.19746/j.cnki.issn.1009-2137.2022.03.015
- Author:
Nai-Cen ZHOU
1
;
Guo-Hui LI
1
;
Wei-Wei QIN
1
;
Wen-Qing WANG
1
;
Huai-Peng GUO
1
;
Cong LIU
1
;
Li LIU
2
Author Information
1. Department of Hematology, The Second Affiliated Hospital of Air Force Medical University (Tangdu Hospital), Xi'an 710038, Shaanxi Province, China.
2. Department of Hematology, The Second Affiliated Hospital of Air Force Medical University (Tangdu Hospital), Xi'an 710038, Shaanxi Province, China,E-mail: liuli1@medmail.com.cn.
- Publication Type:Journal Article
- Keywords:
TET2;
acute myeloid leukemia;
gene mutation
- MeSH:
Aged;
Humans;
Leukemia, Myeloid, Acute/genetics*;
Middle Aged;
Mutation;
Nucleophosmin;
Prognosis;
Retrospective Studies;
fms-Like Tyrosine Kinase 3
- From:
Journal of Experimental Hematology
2022;30(3):755-759
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the characteristics of gene mutation in elderly patients with acute myeloid leukemia (AML) and its effect on prognosis.
METHODS:The clinical and laboratorial characteristics of 54 AML patients (≥60 years old) in Department of Hematology, Tangdu Hospital were analyzed retrospectively during April 2016 to October 2019. Thirty-four AML/myelodysplastic syndrome/myeloproliferative neoplasm related mutant genes were detected by second-generation sequencing technology, and their clinical characteristics, treatment effect, and influence on prognosis were analyzed.
RESULTS:All the patients received DAC+CAG induction treatment, after 1-2 couses of treatment, 36 cases (66.7%) achieved complete response, with a total effective rate of 75.9%, and the median survival time was 17 months. The most frequent mutant genes were TET2 (33.3%), CEBPA (31.5%), DNMT3A (18.5%), ASXL1 (16.7%), NRAS (14.8%), RUNX1 (14.8%), FLT3-ITD (12.9%), TP53 (12.9%), NPM1 (12.9%), and IDH2 (12.9%). Among 7 patients with TP53 mutation, 6 cases obtained complete response after 1-2 courses of induction treatment, but there was no statistically significant difference in the effect on prognosis. Patients with FLT3-ITD and NRAS mutations had shorter overall survival time compared with who had no mutation (P=0.47, P=0.48). Multivariate analysis showed that FLT3-ITD and NRAS mutations were poor prognostic factors.
CONCLUSION:The incidence of TET2 gene mutation is high in elderly AML patients. AML patients with TET2 and TP53 mutations may benefit from Decitabine-based chemotherapy. However, patients with FLT3-ITD and NRAS mutations have a short survival time, and may have a poor prognosis.
