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Prognostic implications of TdT expression in acute myeloid leukemia with an intermediate-risk karyotype

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Abstract

Terminal deoxynucleotidyl transferase (TdT) is expressed on precursor lymphoblastic neoplasms and some acute myeloid leukemia (AML) cells. The clinical impact of TdT expression on AML outcomes remains unclear. Here, we conducted a retrospective analysis to identify prognostic implications of TdT expression in AML with an intermediate-risk karyotype. Forty-eight cases of intermediate-risk AML were enrolled. TdT positivity was defined as expression on ≥ 10% of the gated cells. Of 48 cases, 12 (25%) were positive for TdT [median expression rate of TdT 0.9% (range 0–86.9%)]. No significant differences in patient characteristics or complete remission rate were observed between TdT-positive and TdT-negative cases. The probability of overall survival (OS) and event-free survival (EFS) at 1 year was not significantly different between TdT-positive and TdT-negative cases (OS: 58.3% vs. 65.2%, p = 0.32; EFS: 33.3% vs. 57.1%, p = 0.06). Relapse-free survival (RFS) probability at 1 year was significantly lower for TdT-positive than TdT-negative cases (10% vs. 71.3%, p = 0.002). Multivariate analyses revealed that TdT positivity was an independent significant adverse factor for RFS [hazard ratio: 3.309, 95% confidence interval: 1.334–8.209, p = 0.009]. Our results suggest that TdT expression is associated with increased risk of relapse in patients with intermediate-risk AML.

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Authors and Affiliations

  1. Department of Hematology, Oita Kouseiren Tsurumi Hospital, Oita, Japan

    Masuho Saburi, Kazuhito Itani, Kazuhiro Kohno & Toshiyuki Nakayama

  2. Department of Medical Oncology and Hematology, Faculty of Medicine, Oita University, 1-1 Hasama Idaigaoka, Yuhu City, Oita, 879-5593, Japan

    Masuho Saburi

  3. Department of Hematology, Oita University Hospital, Oita, Japan

    Masao Ogata

  4. Department of Clinical Laboratory, Oita Kouseiren Tsurumi Hospital, Oita, Japan

    Takako Satou & Yasuhiro Soga

  5. Department of Diagnostic Pathology, Oita Kouseiren Tsurumi Hospital, Oita, Japan

    Yoshiyuki Kondo

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  1. Masuho Saburi
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  2. Masao Ogata
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  3. Takako Satou
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  4. Yasuhiro Soga
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  5. Kazuhito Itani
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  6. Kazuhiro Kohno
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  7. Yoshiyuki Kondo
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  8. Toshiyuki Nakayama
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Contributions

MS and MO were responsible for the design of the study, interpretation of the data, and writing the manuscript. KI, KK, and TN treated the patients, collected the samples, and provided patient data. All other authors have contributed to data collection and interpretation, and critically reviewed the manuscript. All authors contributed to the revision of the manuscript and approved the final version.

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Correspondence to Masuho Saburi.

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Saburi, M., Ogata, M., Satou, T. et al. Prognostic implications of TdT expression in acute myeloid leukemia with an intermediate-risk karyotype. Int J Hematol 112, 17–23 (2020). https://doi.org/10.1007/s12185-020-02871-4

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  • DOI: https://doi.org/10.1007/s12185-020-02871-4

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