Title Both the subtypes of KIT mutation and minimal residual disease are associated with prognosis in core binding factor acute myeloid leukemia: a retrospective clinical cohort study in single center
Authors Duan, Wenbing
Liu, Xiaohong
Zhao, Xiaosu
Jia, Jinsong
Wang, Jing
Gong, Lizhong
Jiang, Qian
Zhao, Ting
Wang, Yu
Zhang, Xiaohui
Xu, Lanping
Shi, Hongxia
Chang, Yingjun
Liu, Kaiyan
Huang, Xiaojun
Qin, Yazhen
Jiang, Hao
Affiliation Peking Univ, Peking Univ Peoples Hosp, Inst Hematol, Natl Clin Res Ctr Hematol Dis, Beijing, Peoples R China
Key Lab Hematopoiet Stem Cell Transplantat, Beijing, Peoples R China
Peking Univ, Peking Univ Peoples Hosp, Inst Hematol, Xizhimen South St 11, Beijing 100044, Peoples R China
Issue Date Jan-2021
Publisher ANNALS OF HEMATOLOGY
Abstract Core binding factor acute myeloid leukemia (CBF-AML), including cases with KIT mutation, is currently defined as a low-risk AML. However, some patients have poor response to treatment, and the prognostic significance of KIT mutation is still controversial. This study aimed to explore the prognostic significance of different KIT mutation subtypes and minimal residual disease (MRD) in CBF-AML. We retrospectively evaluated continuous patients diagnosed with CBF-AML in our center between January 2014 and April 2019. Of the 215 patients, 147 (68.4%) and 68 (31.6%) patients were RUNX1-RUNX1T1- and CBFB-MYH11 positive, respectively. KIT mutations were found in 71 (33.0%) patients; of them, 38 (53.5%) had D816/D820 mutations. After excluding 10 patients who died or were lost to follow-up within a half year, 42.0% (n = 86) of the remaining 205 patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT). An MRD > 0.1% at the end of two cycles of consolidation predicted relapse (P < 0.001). Multivariate analysis showed that D816 or D820 mutations and MRD > 0.1% at the end of two cycles of consolidation were independent adverse factors affecting relapse-free survival (RFS) and overall survival (OS). Allo-HSCT could improve RFS (74.4% vs. 34.6%, P < 0.001) and OS (78.1% vs. 52.3%, P = 0.002). In conclusion, high-risk CBF-AML patients must be identified before treatment. D816/D820 mutation, MRD > 0.1% at the end of two cycles of consolidation chemotherapy predicted poor survivals, and allo-HSCT can improve the survival of properly identified patients.
URI http://hdl.handle.net/20.500.11897/608443
ISSN 0939-5555
DOI 10.1007/s00277-021-04432-z
Indexed SCI(E)
Appears in Collections: 人民医院

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