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Mutation profile and prognostic relevance in elderly patients with de novo acute myeloid leukemia treated with decitabine‐based chemotherapy
Author(s) -
Ni Jing,
Hong Jian,
Long Zhangbiao,
Li Qingsheng,
Xia Ruixiang,
Zeng Qingshu
Publication year - 2020
Publication title -
international journal of laboratory hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.705
H-Index - 55
eISSN - 1751-553X
pISSN - 1751-5521
DOI - 10.1111/ijlh.13299
Subject(s) - cebpa , decitabine , medicine , oncology , myeloid leukemia , chemotherapy , leukemia , mutation , gene , biology , genetics , dna methylation , gene expression
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 ( CEBPA single‐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 ( CEBPA double‐mut ), CEBPA single‐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.