Mutation profile and prognostic relevance in elderly patients with de novo acute myeloid leukemia treated with decitabine‐based chemotherapy
Autor: | Qingshu Zeng, Jian Hong, Zhangbiao Long, Jing Ni, Qingsheng Li, Ruixiang Xia |
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Rok vydání: | 2020 |
Předmět: |
Male
Oncology medicine.medical_specialty medicine.medical_treatment Clinical Biochemistry Decitabine 030204 cardiovascular system & hematology Gene mutation IDH2 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine CEBPA medicine Humans Survival analysis Aged Aged 80 and over Chemotherapy business.industry Standard treatment Biochemistry (medical) Myeloid leukemia Hematology General Medicine Middle Aged Prognosis Neoplasm Proteins Leukemia Myeloid Acute Mutation Female business 030215 immunology medicine.drug |
Zdroj: | International Journal of Laboratory Hematology. 42:849-857 |
ISSN: | 1751-553X 1751-5521 |
Popis: | INTRODUCTION Decitabine-based chemotherapy regimens have shown efficacy in the treatment of elderly patients with acute myeloid leukemia (AML). However, it remains unclear whether any molecular alteration is correlated with the therapeutic effect of such treatment regimens. METHODS Gene mutations were detected using next-generation sequencing, and their impact on survival was investigated in elderly AML patients receiving decitabine-based chemotherapy. RESULTS A higher incidence of gene mutations was identified in elderly AML patients than in the younger cohorts. Elderly patients more frequently carried DNMT3A, IDH2, ASXL1, TET2, RUNX1, CEBPA single mutation (CEBPAsingle-mut ), and TP53 mutations. Survival analysis showed that DNMT3A, FLT3-ITD, and TP53 mutations were associated with inferior overall survival (OS) and event-free survival (EFS) in younger AML patients receiving standard treatment. However, in elderly patients treated with decitabine-based chemotherapy, FLT3-ITD, and ASXL1 mutations, but not DNMT3A and TP53 mutations, were associated with poor OS and EFS. Moreover, contrary to CEBPA double mutation (CEBPAdouble-mut ), CEBPAsingle-mut was identified as an unfavorable prognostic factor. CONCLUSION This study comprehensively analyzed the prognostic implications of gene mutations in elderly AML patients under decitabine-based treatment modality. Identification of genetic biomarkers to predict the subgroup of elderly AML patients who can benefit from decitabine-based regimens might have an immediate clinical utility to optimize the treatment of elderly AML patients. |
Databáze: | OpenAIRE |
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