The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia

Abstract To refine the biological and prognostic significance of DNMT3A mutations in acute myeloid leukemia (AML), we assessed the impact of DNMT3A variant allele frequency (VAF) and its comutations in this study. Using targeted next‐generation sequencing, we analyzed 171 adult patients with de novo...

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Main Authors: Xian Chen, Chuchu Tian, Zhuanghui Hao, Lingang Pan, Minglin Hong, Wei Wei, Daniel Muteb Muyey, Hongwei Wang, Xiuhua Chen
Format: Article
Language:English
Published: Wiley 2023-05-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.5764
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author Xian Chen
Chuchu Tian
Zhuanghui Hao
Lingang Pan
Minglin Hong
Wei Wei
Daniel Muteb Muyey
Hongwei Wang
Xiuhua Chen
author_facet Xian Chen
Chuchu Tian
Zhuanghui Hao
Lingang Pan
Minglin Hong
Wei Wei
Daniel Muteb Muyey
Hongwei Wang
Xiuhua Chen
author_sort Xian Chen
collection DOAJ
description Abstract To refine the biological and prognostic significance of DNMT3A mutations in acute myeloid leukemia (AML), we assessed the impact of DNMT3A variant allele frequency (VAF) and its comutations in this study. Using targeted next‐generation sequencing, we analyzed 171 adult patients with de novo cytogenetically normal AML for DNMT3A mutations and associated comutations. DNMT3Amut was detected in 35 patients. DNMT3Amut patients were divided into DNMT3AHigh and DNMT3ALow using a cut‐off VAF value of 42%. We observed that DNMT3AHigh patients at diagnosis had increasing white blood cell (WBC) counts (p < 0.001) and a higher lactate dehydrogenase (LDH) level (p = 0.027), and were associated with lower complete remission (CR) rate (p = 0.015) and shorter overall survival (OS) (p = 0.032) than DNMT3ALow patients. We classified two different comutated genetypes, including DNMT3AmutNPM1mutFLT3‐ITDmut and DNMT3AmutIDH1/IDH2mut. Patients with DNMT3AmutNPM1mutFLT3‐ITDmut showed worse OS (p = 0.026) and relapse‐free survival (RFS) (p = 0.003) than those with DNMT3AmutIDH1/IDH2mut, and showed a shorter OS (p = 0.027) than those with DNMT3AwtNPM1mutFLT3‐ITDmut. We also observed that patients with DNMT3AmutIDH1/IDH2mut had higher platelet counts (p = 0.009) and a lower BM blast percentage (p = 0.040) than those with DNMT3AwtIDH1/IDH2mut. In multivariate analyses, DNMT3AHigh was independently associated with a lower CR rate (OR = 5.883; p = 0.004) and shorter OS (HR = 3.768; p < 0.001). DNMT3AmutNPM1mutFLT3‐ITDmut independently affected worse OS (HR = 6.030; p < 0.001) and RFS (HR = 8.939; p < 0.001). Our findings might be potentially useful for predicting clinical outcomes.
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spelling doaj.art-88a768f1e89a44f196fb50c7c98c5e3b2023-05-28T20:33:59ZengWileyCancer Medicine2045-76342023-05-01129103401035010.1002/cam4.5764The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemiaXian Chen0Chuchu Tian1Zhuanghui Hao2Lingang Pan3Minglin Hong4Wei Wei5Daniel Muteb Muyey6Hongwei Wang7Xiuhua Chen8Institute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaInstitute of Hematology The Second Hospital of Shanxi Medical University Taiyuan ChinaAbstract To refine the biological and prognostic significance of DNMT3A mutations in acute myeloid leukemia (AML), we assessed the impact of DNMT3A variant allele frequency (VAF) and its comutations in this study. Using targeted next‐generation sequencing, we analyzed 171 adult patients with de novo cytogenetically normal AML for DNMT3A mutations and associated comutations. DNMT3Amut was detected in 35 patients. DNMT3Amut patients were divided into DNMT3AHigh and DNMT3ALow using a cut‐off VAF value of 42%. We observed that DNMT3AHigh patients at diagnosis had increasing white blood cell (WBC) counts (p < 0.001) and a higher lactate dehydrogenase (LDH) level (p = 0.027), and were associated with lower complete remission (CR) rate (p = 0.015) and shorter overall survival (OS) (p = 0.032) than DNMT3ALow patients. We classified two different comutated genetypes, including DNMT3AmutNPM1mutFLT3‐ITDmut and DNMT3AmutIDH1/IDH2mut. Patients with DNMT3AmutNPM1mutFLT3‐ITDmut showed worse OS (p = 0.026) and relapse‐free survival (RFS) (p = 0.003) than those with DNMT3AmutIDH1/IDH2mut, and showed a shorter OS (p = 0.027) than those with DNMT3AwtNPM1mutFLT3‐ITDmut. We also observed that patients with DNMT3AmutIDH1/IDH2mut had higher platelet counts (p = 0.009) and a lower BM blast percentage (p = 0.040) than those with DNMT3AwtIDH1/IDH2mut. In multivariate analyses, DNMT3AHigh was independently associated with a lower CR rate (OR = 5.883; p = 0.004) and shorter OS (HR = 3.768; p < 0.001). DNMT3AmutNPM1mutFLT3‐ITDmut independently affected worse OS (HR = 6.030; p < 0.001) and RFS (HR = 8.939; p < 0.001). Our findings might be potentially useful for predicting clinical outcomes.https://doi.org/10.1002/cam4.5764acute myeloid leukemiaDNMT3A mutationsvariant allele frequency
spellingShingle Xian Chen
Chuchu Tian
Zhuanghui Hao
Lingang Pan
Minglin Hong
Wei Wei
Daniel Muteb Muyey
Hongwei Wang
Xiuhua Chen
The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
Cancer Medicine
acute myeloid leukemia
DNMT3A mutations
variant allele frequency
title The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
title_full The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
title_fullStr The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
title_full_unstemmed The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
title_short The impact of DNMT3A variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
title_sort impact of dnmt3a variant allele frequency and two different comutations on patients with de novo cytogenetically normal acute myeloid leukemia
topic acute myeloid leukemia
DNMT3A mutations
variant allele frequency
url https://doi.org/10.1002/cam4.5764
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