Comparison of therapy-related and de novo core binding factor acute myeloid leukemia: A bone marrow pathology group study.


Journal

American journal of hematology
ISSN: 1096-8652
Titre abrégé: Am J Hematol
Pays: United States
ID NLM: 7610369

Informations de publication

Date de publication:
07 2020
Historique:
received: 07 01 2020
revised: 20 03 2020
accepted: 30 03 2020
pubmed: 7 4 2020
medline: 18 8 2020
entrez: 7 4 2020
Statut: ppublish

Résumé

This multi-institutional study retrospectively evaluated clinicopathologic and genetic characteristics in 351 patients with core-binding-factor acute myeloid leukemia (CBF-AML), comprising 69 therapy-related (t-CBF-AML) and 282 de novo cases. The T-CBF-AML patients were older, had lower WBC counts, and slightly higher hemoglobin than patients with de novo disease. Secondary cytogenetic abnormalities were more frequent in patients with de novo disease than t-CBF-AML (57.1% vs 41.1%, P = .026). Patients with secondary cytogenetic abnormalities had longer overall survival (OS) than those without abnormalities (median 190 vs 87 months, P = .021); trisomy 8, trisomy 22, and loss of the X or Y chromosome were associated with longer OS. In the 165 cases performed of targeted gene sequencing, pathogenic mutations were detected in 75.7% of cases, and were more frequent in de novo than in therapy-related disease (P = .013). Mutations were found in N/KRAS (37.0%), FLT3 (27.8%), KIT (17.2%), TET2 (4.9%), and ASXL1 (3.9%). The TET2 mutations were associated with shorter OS (P = .012) while N/KRAS mutation was associated with longer OS in t(8;21) AML patients (P = .001). The KIT mutation did not show prognostic significance in this cohort. Although they received similar therapy, t-CBF-AML patients had shorter OS than de novo patients (median 69 vs 190 months, P = .038). In multivariate analysis of all patients, older age and absence of any secondary cytogenetic abnormalities were significant predictors of shorter OS. Among the t-CBF-AML subset, age and hemoglobin were significant on multivariate analysis. This study demonstrated that although de novo and t-CBF-AML patients share many features, t-CBF-AML patients have worse clinical outcome than de novo patients.

Identifiants

pubmed: 32249963
doi: 10.1002/ajh.25814
doi:

Substances chimiques

Core Binding Factors 0
Neoplasm Proteins 0

Types de publication

Clinical Trial Comparative Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

799-808

Informations de copyright

© 2020 Wiley Periodicals, Inc.

Références

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Auteurs

Heesun J Rogers (HJ)

Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

Xiaoqiong Wang (X)

Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

Yan Xie (Y)

Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

Adam R Davis (AR)

Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Beenu Thakral (B)

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Sa A Wang (SA)

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Gautam Borthakur (G)

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Miguel D Cantu (MD)

Department of Pathology, Weill Cornell Medicine, New York, New York, USA.

Elizabeth M Margolskee (EM)

Department of Pathology, Weill Cornell Medicine, New York, New York, USA.

John K S Philip (JKS)

Department of Pathology, University of Chicago, Chicago, Illinois, USA.

Madina Sukhanova (M)

Department of Pathology, Northwestern University, Chicago, Illinois, USA.

Adam Bagg (A)

Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Carlos E Bueso-Ramos (CE)

Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Attilio Orazi (A)

Department of Pathology, Texas Tech University Health Science Center, El Paso, Texas, USA.

Daniel A Arber (DA)

Department of Pathology, University of Chicago, Chicago, Illinois, USA.

Eric D Hsi (ED)

Department of Laboratory Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

Robert P Hasserjian (RP)

Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA.

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