Clinical characteristics of EVI1+ AML and clinical observation of hematopoietic stem cell transplantation on these patients

Abstract

Objective To investigate the clinical characteristics, treatment response, and prognosis of acute myeloid leukemia (AML) with high expression of EVI1 and the effectiveness of hematopoietic stem cell transplantation (HSCT).MethodsA total of 7 subjects diagnosed with EVI1+ AML in our center from January 2016 to May 2020 were enrolled in this study. They were 1 male and 6 females, and at a median age of 8 (3～49) years. The expression level of EVI1 gene was measured by nested PCR, analyzed together with morphological type, cytogenetics and molecular biology data of bone marrow. To characterize the clinical features of EVI1+ AML and to observe the therapeutic effect of hematopoietic stem cell transplantation.Results The results of risk stratification showed that all these EVI1+ AML patients were at high risk. By the end of follow-up on May 31, 2020, 2 patients relapsed during standard chemotherapy. For the 6 patients undergoing allogeneic HSCT (allo-HSCT), 5 achieved complete remission (CR) before transplantation, and the other 1 only achieved secondary CR after salvage transplantation. One patient relapsed during standard chemotherapy, did not receive transplantation, and died 10 months after diagnosis. All 6 patients who received allo-HSCT stayed in remission by the end of the study. Conclusion EVI1+ AML patients have poor outcomes, and are at high risk of relapse, but achieve sound CR, with M4 and M5 more commonly. Allo-HSCT can significantly improve the prognosis of EVI1+ AML patients.

Keywords

• acute myeloid leukemia
• evi1 gene
• hematopoietic stem cell transplantation
• prognosis