Genotypic and clinical heterogeneity within NCCN favorable-risk acute myeloid leukemia.

Abstract:

:The National Comprehensive Cancer Network (NCCN) defines the following types of acute myeloid leukemia (AML) as favorable-risk: acute promyelocytic leukemia with t(15;17) (APL); AML with core-binding factor (CBF) rearrangements, including t(8;21) and inv(16) or t(16;16) without mutations in KIT (CBF-KITwt); and AML with normal cytogenetics and mutations in NPM1 (NPM1mut); or biallelic mutations in CEBPA (CEBPAmut/mut), without FLT3-ITD. Although these AMLs are categorized as favorable risk by NCCN, clinical experience suggests that there are differences in clinical outcome amongst these cytogenetically and molecularly distinct leukemias. This study compared clinical and genotypic characteristics of 60 patients with favorable-risk AML, excluding APL, and demonstrated significant differences between them. Patients with NPM1mut AML were significantly older than those in the other groups. Targeted next-generation sequencing on DNA from peripheral blood or bone marrow revealed significantly more mutations in NPM1mut AML than the other favorable-risk diseases, especially in genes related to DNA splicing and methylation. CEBPAmut/mut AMLs exhibited more mutations in transcription-related genes. Patients with NPM1mut AML and CEBPAmut/mut AML show significantly reduced overall survival in comparison with CBF-KITwt AML. These findings emphasize that favorable-risk AML patients have divergent outcomes and that differences in clinical and genotypic characteristics should be considered in their evaluation and management.

journal_name

Leuk Res

journal_title

Leukemia research

authors

Strickland SA,Shaver AC,Byrne M,Daber RD,Ferrell PB,Head DR,Mohan SR,Mosse CA,Moyo TK,Stricker TP,Vnencak-Jones C,Savona MR,Seegmiller AC

doi

10.1016/j.leukres.2017.12.012

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

67-73

eissn

0145-2126

issn

1873-5835

pii

S0145-2126(17)30617-3

journal_volume

65

pub_type

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