The value of molecular stratification for CEBPADM and NPM1MUTFLT3WT genotypes in older patients with acute myeloid leukaemia |
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| Authors: | Glenda J. Dickson Sophia Bustraan Robert K. Hills Akbar Ali Anthony H. Goldstone Alan K. Burnett David C. Linch Rosemary E. Gale |
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| Affiliation: | 1. Department of Haematology, University College London Cancer Institute, London, UK;2. Department of Haematology, Cardiff University School of Medicine, Cardiff, UK;3. Department of Haematology, University College London Hospital, London, UK |
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| Abstract: | Older adult patients (≥60 years) with acute myeloid leukaemia (AML) are generally considered to be poor‐risk and there is limited information available regarding risk stratification based on molecular characterization in this age group, particularly for the double‐mutant CEBPA (CEBPADM) genotype. To investigate whether a molecular favourable‐risk genotype can be identified, we investigated CEBPA, NPM1 and FLT3 status and prognostic impact in a cohort of 301 patients aged 60 years or more with intermediate‐risk cytogenetics, all treated intensively. Overall survival (OS) at 1 year was highest in the 12 patients (4%) that were CEBPADM compared to the 76 (28%) with a mutant NPM1 and wild‐type FLT3 (NPM1MUTFLT3WT) genotype or all other patients (75%, 54%, 33% respectively), with median survival 15·2, 13·6 and 6·6 months, although the benefit was short‐term (OS at 3 years 17%, 29%, 12% respectively). Combination of the CEBPADM and NPM1MUTFLT3WT genotype patients defined a molecular group with favourable prognosis (P < 0·0001 in multivariate analysis), with 57% of patients alive at 1 year compared to 33% for all other patients. Knowledge of genotype in older cytogenetically intermediate‐risk patients might influence therapy decisions. |
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| Keywords: | acute myeloid leukaemia molecular prognostication CEBPA genotype NPM1 and FLT3 genotype |
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