Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia

Disease relapse is the major cause of treatment failure after allogeneic stem cell transplantation (allo-SCT) in acute myeloid leukemia (AML). To identify AML-associated genes prognostic of AML relapse post–allo-SCT, we resequenced 35 genes in 113 adults at diagnosis, 49 of whom relapsed. Two hundre...

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Váldodahkkit: Quek, L, Ferguson, P, Metzner, M, Ahmed, I, Kennedy, A, Garnett, C, Jeffries, S, Walter, C, Piechocki, K, Timbs, A, Danby, R, Raghavan, M, Peniket, A, Griffiths, M, Bacon, A, Ward, J, Wheatley, K, Vyas, P, Craddock, C
Materiálatiipa: Journal article
Giella:English
Almmustuhtton: American Society of Hematology 2016
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author Quek, L
Ferguson, P
Metzner, M
Ahmed, I
Kennedy, A
Garnett, C
Jeffries, S
Walter, C
Piechocki, K
Timbs, A
Danby, R
Raghavan, M
Peniket, A
Griffiths, M
Bacon, A
Ward, J
Wheatley, K
Vyas, P
Craddock, C
author_facet Quek, L
Ferguson, P
Metzner, M
Ahmed, I
Kennedy, A
Garnett, C
Jeffries, S
Walter, C
Piechocki, K
Timbs, A
Danby, R
Raghavan, M
Peniket, A
Griffiths, M
Bacon, A
Ward, J
Wheatley, K
Vyas, P
Craddock, C
author_sort Quek, L
collection OXFORD
description Disease relapse is the major cause of treatment failure after allogeneic stem cell transplantation (allo-SCT) in acute myeloid leukemia (AML). To identify AML-associated genes prognostic of AML relapse post–allo-SCT, we resequenced 35 genes in 113 adults at diagnosis, 49 of whom relapsed. Two hundred sixty-two mutations were detected in 102/113 (90%) patients. An increased risk of relapse was observed in patients with mutations in WT1 (P = .018), DNMT3A (P = .045), FLT3 ITD (P = .071), and TP53 (P = .06), whereas mutations in IDH1 were associated with a reduced risk of disease relapse (P = .018). In 29 patients, we additionally compared mutational profiles in bone marrow at diagnosis and relapse to study changes in clonal structure at relapse. In 13/29 patients, mutational profiles altered at relapse. In 9 patients, mutations present at relapse were not detected at diagnosis. In 15 patients, additional available pre–allo-SCT samples demonstrated that mutations identified posttransplant but not at diagnosis were detectable immediately prior to transplant in 2 of 15 patients. Taken together, these observations, if confirmed in larger studies, have the potential to inform the design of novel strategies to reduce posttransplant relapse highlighting the potential importance of post–allo-SCT interventions with a broad antitumor specificity in contrast to targeted therapies based on mutational profile at diagnosis.
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spelling oxford-uuid:5f3c3ec6-1b7e-4b4c-9e53-8c2b4b90ce602022-03-26T17:46:01ZMutational analysis of disease relapse in patients allografted for acute myeloid leukemiaJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5f3c3ec6-1b7e-4b4c-9e53-8c2b4b90ce60EnglishSymplectic Elements at OxfordAmerican Society of Hematology2016Quek, LFerguson, PMetzner, MAhmed, IKennedy, AGarnett, CJeffries, SWalter, CPiechocki, KTimbs, ADanby, RRaghavan, MPeniket, AGriffiths, MBacon, AWard, JWheatley, KVyas, PCraddock, CDisease relapse is the major cause of treatment failure after allogeneic stem cell transplantation (allo-SCT) in acute myeloid leukemia (AML). To identify AML-associated genes prognostic of AML relapse post–allo-SCT, we resequenced 35 genes in 113 adults at diagnosis, 49 of whom relapsed. Two hundred sixty-two mutations were detected in 102/113 (90%) patients. An increased risk of relapse was observed in patients with mutations in WT1 (P = .018), DNMT3A (P = .045), FLT3 ITD (P = .071), and TP53 (P = .06), whereas mutations in IDH1 were associated with a reduced risk of disease relapse (P = .018). In 29 patients, we additionally compared mutational profiles in bone marrow at diagnosis and relapse to study changes in clonal structure at relapse. In 13/29 patients, mutational profiles altered at relapse. In 9 patients, mutations present at relapse were not detected at diagnosis. In 15 patients, additional available pre–allo-SCT samples demonstrated that mutations identified posttransplant but not at diagnosis were detectable immediately prior to transplant in 2 of 15 patients. Taken together, these observations, if confirmed in larger studies, have the potential to inform the design of novel strategies to reduce posttransplant relapse highlighting the potential importance of post–allo-SCT interventions with a broad antitumor specificity in contrast to targeted therapies based on mutational profile at diagnosis.
spellingShingle Quek, L
Ferguson, P
Metzner, M
Ahmed, I
Kennedy, A
Garnett, C
Jeffries, S
Walter, C
Piechocki, K
Timbs, A
Danby, R
Raghavan, M
Peniket, A
Griffiths, M
Bacon, A
Ward, J
Wheatley, K
Vyas, P
Craddock, C
Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
title Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
title_full Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
title_fullStr Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
title_full_unstemmed Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
title_short Mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
title_sort mutational analysis of disease relapse in patients allografted for acute myeloid leukemia
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