Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML
Abstract A set of myelodysplasia-related (MDS-R) gene mutations are incorporated into the 2022 European LeukemiaNet risk classification as adverse genetic factors for acute myeloid leukemia (AML) based on their poor prognostic impact on older patients. The impact of these mutations on younger patien...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2023-01-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-022-00774-7 |
| _version_ | 1828069764992335872 |
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| author | Xavier Cheng-Hong Tsai Kuo-Jui Sun Min-Yen Lo Feng-Ming Tien Yuan-Yeh Kuo Mei-Hsuan Tseng Yen-Ling Peng Yi-Kuang Chuang Bor-Sheng Ko Jih-Luh Tang Hsun-I Sun Ming-Chih Liu Chia-Wen Liu Chien-Chin Lin Ming Yao Wen-Chien Chou Hsin-An Hou Hwei-Fang Tien |
| author_facet | Xavier Cheng-Hong Tsai Kuo-Jui Sun Min-Yen Lo Feng-Ming Tien Yuan-Yeh Kuo Mei-Hsuan Tseng Yen-Ling Peng Yi-Kuang Chuang Bor-Sheng Ko Jih-Luh Tang Hsun-I Sun Ming-Chih Liu Chia-Wen Liu Chien-Chin Lin Ming Yao Wen-Chien Chou Hsin-An Hou Hwei-Fang Tien |
| author_sort | Xavier Cheng-Hong Tsai |
| collection | DOAJ |
| description | Abstract A set of myelodysplasia-related (MDS-R) gene mutations are incorporated into the 2022 European LeukemiaNet risk classification as adverse genetic factors for acute myeloid leukemia (AML) based on their poor prognostic impact on older patients. The impact of these mutations on younger patients (age < 60 years) remains elusive. In the study of 1213 patients with de novo non-M3 AML, we identified MDS-R mutations in 32.7% of the total cohort, 44.9% of older patients and 23.4% of younger patients. The patients with MDS-R mutations had a significantly lower complete remission rate in both younger and older age groups. With a median follow-up of 9.2 years, the MDS-R group experienced shorter overall survival (P = 0.034 for older and 0.035 for younger patients) and event-free survival (P = 0.004 for older and 0.042 for younger patients). Furthermore, patients with MDS-R mutations more frequently harbored measurable residual disease that was detectable using next generation sequencing at morphological CR than those without MDS-R mutations. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) might ameliorate the negative impact of MDS-R mutations. In summary, AML patients with MDS-R mutations have significantly poorer outcomes regardless of age. More intensive treatment, such as allo-HSCT and/or novel therapies, is warranted for AML patients with MDS-R mutations. |
| first_indexed | 2024-04-11T00:24:22Z |
| format | Article |
| id | doaj.art-b596d2b3efd1497b8eea73005ee3a8d3 |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-04-11T00:24:22Z |
| publishDate | 2023-01-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-b596d2b3efd1497b8eea73005ee3a8d32023-01-08T12:05:11ZengNature Publishing GroupBlood Cancer Journal2044-53852023-01-0113111110.1038/s41408-022-00774-7Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AMLXavier Cheng-Hong Tsai0Kuo-Jui Sun1Min-Yen Lo2Feng-Ming Tien3Yuan-Yeh Kuo4Mei-Hsuan Tseng5Yen-Ling Peng6Yi-Kuang Chuang7Bor-Sheng Ko8Jih-Luh Tang9Hsun-I Sun10Ming-Chih Liu11Chia-Wen Liu12Chien-Chin Lin13Ming Yao14Wen-Chien Chou15Hsin-An Hou16Hwei-Fang Tien17Department of Medical Education and Research, National Taiwan University Hospital Yunlin BranchDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalDivision of Hematology, Department of Internal Medicine, National Taiwan University Hospital Yunlin BranchDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalTai-Chen Cell Therapy Center, National Taiwan UniversityTai-Chen Cell Therapy Center, National Taiwan UniversityDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalTai-Chen Cell Therapy Center, National Taiwan UniversityDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalDepartment of Hematological Oncology, National Taiwan University Cancer Center, National Taiwan University HospitalTai-Chen Cell Therapy Center, National Taiwan UniversityDepartment of Pathology, National Taiwan University HospitalDepartment of Pathology, National Taiwan University HospitalDepartment of Laboratory Medicine, National Taiwan University HospitalDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalDivision of Hematology, Department of Internal Medicine, National Taiwan University HospitalAbstract A set of myelodysplasia-related (MDS-R) gene mutations are incorporated into the 2022 European LeukemiaNet risk classification as adverse genetic factors for acute myeloid leukemia (AML) based on their poor prognostic impact on older patients. The impact of these mutations on younger patients (age < 60 years) remains elusive. In the study of 1213 patients with de novo non-M3 AML, we identified MDS-R mutations in 32.7% of the total cohort, 44.9% of older patients and 23.4% of younger patients. The patients with MDS-R mutations had a significantly lower complete remission rate in both younger and older age groups. With a median follow-up of 9.2 years, the MDS-R group experienced shorter overall survival (P = 0.034 for older and 0.035 for younger patients) and event-free survival (P = 0.004 for older and 0.042 for younger patients). Furthermore, patients with MDS-R mutations more frequently harbored measurable residual disease that was detectable using next generation sequencing at morphological CR than those without MDS-R mutations. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) might ameliorate the negative impact of MDS-R mutations. In summary, AML patients with MDS-R mutations have significantly poorer outcomes regardless of age. More intensive treatment, such as allo-HSCT and/or novel therapies, is warranted for AML patients with MDS-R mutations.https://doi.org/10.1038/s41408-022-00774-7 |
| spellingShingle | Xavier Cheng-Hong Tsai Kuo-Jui Sun Min-Yen Lo Feng-Ming Tien Yuan-Yeh Kuo Mei-Hsuan Tseng Yen-Ling Peng Yi-Kuang Chuang Bor-Sheng Ko Jih-Luh Tang Hsun-I Sun Ming-Chih Liu Chia-Wen Liu Chien-Chin Lin Ming Yao Wen-Chien Chou Hsin-An Hou Hwei-Fang Tien Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML Blood Cancer Journal |
| title | Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML |
| title_full | Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML |
| title_fullStr | Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML |
| title_full_unstemmed | Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML |
| title_short | Poor prognostic implications of myelodysplasia-related mutations in both older and younger patients with de novo AML |
| title_sort | poor prognostic implications of myelodysplasia related mutations in both older and younger patients with de novo aml |
| url | https://doi.org/10.1038/s41408-022-00774-7 |
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