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Correlation Analysis and Prognostic Impacts of Biological Characteristics in Elderly Patients with Acute Myeloid Leukemia
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2022-08-07 , DOI: 10.2147/cia.s375000 Fengli Li 1 , Na Li 2 , Anyou Wang 1, 2 , Xin Liu 1, 2
Clinical Interventions in Aging ( IF 3.6 ) Pub Date : 2022-08-07 , DOI: 10.2147/cia.s375000 Fengli Li 1 , Na Li 2 , Anyou Wang 1, 2 , Xin Liu 1, 2
Affiliation
Background: The significant heterogeneity of elderly AML patients’ biological features has caused stratification difficulties and adverse prognosis. This paper did a correlation study between their genetic mutations, clinical features, and prognosis to further stratify them.
Methods: 90 newly diagnosed elderly acute myeloid leukemia (AML) patients (aged ≥ 60 years) who detected genetic mutations by next-generation sequencing (NGS) were enrolled between April 2015 and March 2021 in our medical center.
Results: A total of 29 genetic mutations were identified in 82 patients among 90 cases with a frequency of 91.1%. DNMT3A, BCOR, U2AF1, and BCORL1 mutations were unevenly distributed among different FAB classifications (p < 0.05). DNMT3A, IDH2, NPM1, FLT3-ITD, ASXL1, IDH1, SRSF2, BCOR, NRAS, RUNX1, U2AF1, MPO, and WT1 mutations were distributed differently when an immunophenotype was expressed or not expressed (p< 0.05). NPM1 and FLT3-ITD had higher mutation frequencies in patients with normal chromosome karyotypes than abnormal chromosome karyotypes (p< 0.001, p=0.005). DNMT3A and NRAS mutations predicted lower CR rates. DNMT3A, TP53, and U2AF1 mutations were related to unfavorable OS. TET2 mutation with CD123+, CD11b+ or CD34- predicted lower CR rate. IDH2+/CD34- predicted lower CR rate. ASXL1+/CD38+ and SRSF2+/CD123- predicted shorter OS.
Conclusion: The study showed specific correlations between elderly AML patients’ genetic mutations and clinical features, some of which may impact prognosis.
中文翻译：
老年急性髓系白血病患者生物学特征相关性分析及预后影响
背景：老年AML患者生物学特征的显着异质性导致分层困难和不良预后。本文对它们的基因突变、临床特征和预后进行了相关性研究，以进一步对其进行分层。
方法： 2015 年 4 月至 2021 年 3 月期间，90 例通过二代测序（NGS）检测到基因突变的新诊断老年急性髓细胞白血病（AML）患者（年龄≥60 岁）入组。
结果： 90例患者中82例患者共发现29个基因突变，发生率91.1%。DNMT3A、BCOR、U2AF1 和 BCORL1 突变在不同的 FAB 分类中分布不均（p< 0.05)。当免疫表型表达或不表达时，DNMT3A、IDH2、NPM1、FLT3-ITD、ASXL1、IDH1、SRSF2、BCOR、NRAS、RUNX1、U2AF1、MPO 和 WT1 突变分布不同（p < 0.05）。NPM1和FLT3-ITD在染色体核型正常的患者中的突变频率高于染色体核型异常的患者（p < 0.001，p = 0.005）。DNMT3A 和 NRAS 突变预测较低的 CR 率。DNMT3A、TP53 和 U2AF1 突变与不利的 OS 有关。TET2 突变与 CD123+、CD11b+ 或 CD34- 预测较低的 CR 率。IDH2+/CD34- 预测较低的 CR 率。ASXL1+/CD38+ 和 SRSF2+/CD123- 预测 OS 更短。
结论：该研究表明老年 AML 患者的基因突变与临床特征之间存在特定的相关性，其中一些可能会影响预后。
更新日期：2022-08-07
Methods: 90 newly diagnosed elderly acute myeloid leukemia (AML) patients (aged ≥ 60 years) who detected genetic mutations by next-generation sequencing (NGS) were enrolled between April 2015 and March 2021 in our medical center.
Results: A total of 29 genetic mutations were identified in 82 patients among 90 cases with a frequency of 91.1%. DNMT3A, BCOR, U2AF1, and BCORL1 mutations were unevenly distributed among different FAB classifications (p < 0.05). DNMT3A, IDH2, NPM1, FLT3-ITD, ASXL1, IDH1, SRSF2, BCOR, NRAS, RUNX1, U2AF1, MPO, and WT1 mutations were distributed differently when an immunophenotype was expressed or not expressed (p< 0.05). NPM1 and FLT3-ITD had higher mutation frequencies in patients with normal chromosome karyotypes than abnormal chromosome karyotypes (p< 0.001, p=0.005). DNMT3A and NRAS mutations predicted lower CR rates. DNMT3A, TP53, and U2AF1 mutations were related to unfavorable OS. TET2 mutation with CD123+, CD11b+ or CD34- predicted lower CR rate. IDH2+/CD34- predicted lower CR rate. ASXL1+/CD38+ and SRSF2+/CD123- predicted shorter OS.
Conclusion: The study showed specific correlations between elderly AML patients’ genetic mutations and clinical features, some of which may impact prognosis.
中文翻译：
老年急性髓系白血病患者生物学特征相关性分析及预后影响
背景：老年AML患者生物学特征的显着异质性导致分层困难和不良预后。本文对它们的基因突变、临床特征和预后进行了相关性研究，以进一步对其进行分层。
方法： 2015 年 4 月至 2021 年 3 月期间，90 例通过二代测序（NGS）检测到基因突变的新诊断老年急性髓细胞白血病（AML）患者（年龄≥60 岁）入组。
结果： 90例患者中82例患者共发现29个基因突变，发生率91.1%。DNMT3A、BCOR、U2AF1 和 BCORL1 突变在不同的 FAB 分类中分布不均（p< 0.05)。当免疫表型表达或不表达时，DNMT3A、IDH2、NPM1、FLT3-ITD、ASXL1、IDH1、SRSF2、BCOR、NRAS、RUNX1、U2AF1、MPO 和 WT1 突变分布不同（p < 0.05）。NPM1和FLT3-ITD在染色体核型正常的患者中的突变频率高于染色体核型异常的患者（p < 0.001，p = 0.005）。DNMT3A 和 NRAS 突变预测较低的 CR 率。DNMT3A、TP53 和 U2AF1 突变与不利的 OS 有关。TET2 突变与 CD123+、CD11b+ 或 CD34- 预测较低的 CR 率。IDH2+/CD34- 预测较低的 CR 率。ASXL1+/CD38+ 和 SRSF2+/CD123- 预测 OS 更短。
结论：该研究表明老年 AML 患者的基因突变与临床特征之间存在特定的相关性，其中一些可能会影响预后。
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