Clinical Interventions in Aging (Aug 2022)
Correlation Analysis and Prognostic Impacts of Biological Characteristics in Elderly Patients with Acute Myeloid Leukemia
Abstract
Fengli Li,1 Na Li,2 Anyou Wang,1,2 Xin Liu1,2 1Department of Hematology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei, People’s Republic of China; 2Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People’s Republic of ChinaCorrespondence: Xin Liu, Department of Hematology, Anhui Provincial Hospital Affiliated to Anhui Medical University, Lujiang Road No. 17, Hefei, 230001, People’s Republic of China, Tel/Fax +86-551-62283863, Email [email protected] Anyou Wang, Department of Hematology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Lujiang Road No. 17, Hefei, 230001, People’s Republic of China, Tel/Fax +86-551-62283863, Email [email protected]: 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.Keywords: elderly AML, genetic mutation, FAB subtype, karyotype, immunophenotype, prognosis
