Analysis of prognostic factors for patients with AML1::ETO-positive acute myeloid leukemia
10.3760/cma.j.cn115356-20240424-00058
- VernacularTitle:AML1：：ETO融合基因阳性急性髓系白血病患者预后影响因素分析
- Author:
Shujuan WANG
1
;
Yu HE
;
Lijuan CUI
Author Information
1. 宁夏医科大学，银川 750004
- Keywords:
Leukemia, myeloid, acute;
Prognosis;
AML1::ETO fusion gene
- From:
Journal of Leukemia & Lymphoma
2025;34(5):296-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the prognostic factors of patients with AML1::ETO-positive acute myeloid leukemia (AML).Methods:A retrospective cohort study was conducted. The clinical data of 42 AML1::ETO-positive AML patients diagnosed in the General Hospital of Ningxia Medical University from November 2012 to December 2023 were collected. The general clinical characteristics and short-term efficacy of patients were summarized, and the Kaplan-Meier method was used to analyze the overall survival (OS) and recurrence-free survival (RFS) of stratified patients based on factors such as age, gender, blood cell count, immunophenotype, treatment plan, and efficacy, and the log-rank test was used for inter-group comparison. Cox proportional hazards model was used for univariate and multivariate analyses on OS and RFS.Results:Among the 42 patients, there were 22 males (52.4%) and 20 females (47.6%), with a median age of 35 years, ranged from 14 to 66 years. The common initial symptoms included fatigue, fever and bleeding. The proportions of patients with CD19 or CD56 positivity were both 54.8% (23/42). Twenty-two cases (52.4%) received IA (idarubicin+cytarabine) regimen, 8 cases (19.1%) received HAA (homoharringtonine+cytarabine+aclarubicin) regimen, and 12 cases (28.6%) received induction chemotherapy with other regimens. Seven patients (16.7%) received hematopoietic stem cell transplantation (HSCT) during subsequent treatment. After one course of induction therapy, 29 cases (69.1%) achieved complete remission (CR). The proportions of patients in the CR group with initial platelet count > 10×10 9/L [86.2% (25/29) vs. 53.8% (7/13)], CD19 positivity [65.5% (19/29) vs. 30.8% (4/13)], CD56 negativity [58.6% (17/29) vs. 15.4% (2/13)], CD34 positivity [96.7% (28/29) vs. 76.9% (10/13)], and IA regimen treatment [58.6% (17/29) vs. 38.5% (5/13)] were higher than those in the non-CR group, and the differences were statistically significant (all P < 0.05). There were no statistically significant differences in the proportions of patients stratified by gender, age, hemoglobin, chromosomal karyotype, and with or without c-kit mutation (all P > 0.05). The median follow-up time was 19.5 months, ranged from 0.9 to 133.0 months. Kaplan-Meier analysis showed that patients with initial platelet count > 10×10 9/L, CD19 positivity, CD56 negativity, non-c-kit mutation, CR after one course of treatment, and subsequent HSCT had good OS and RFS (all P < 0.05). Multivariate Cox regression analysis showed that platelet count (> 10×10 9/L vs. ≤ 10×10 9/L, HR = 0.046, 95% CI: 0.007-0.314, P = 0.002), CD19 expression (positivity vs. negativity, HR = 0.069, 95% CI: 0.010-0.495, P = 0.008), CD56 expression (positivity vs. negativity, HR = 6.478, 95% CI: 1.178-35.631, P = 0.032), CD34 expression (positivity vs. negativity, HR = 38.300, 95% CI: 2.061-711.647, P = 0.014) and CR after one course of treatment (yes vs. no, HR = 0.076, 95% CI: 0.011-0.518, P = 0.008) were independent influencing factors for OS in AML1::ETO-positive AML patients. Platelet count (> 10×10 9/L vs. ≤ 10×10 9/L, HR = 0.101, 95% CI: 0.019-0.540, P = 0.007), CD19 expression (positivity vs. negativity, HR = 0.056, 95% CI: 0.007-0.462, P = 0.007) and CD56 expression (positivity vs. negativity, HR = 7.287, 95% CI: 1.096-48.457, P = 0.040) were independent influencing factors for RFS in AML1:: ETO-positive AML patients. Conclusions:Platelet count > 10×10 9/L and CD19 positivity may indicate a good prognosis for AML patients with AML1::ETO fusion gene, while CD56 positivity may indicate a poor prognosis.
