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Title: The value of molecular stratification for CEBPA(DM) and NPM1(MUT) FLT3(WT) genotypes in older patients with acute myeloid leukaemia.
Authors: Dickson, Glenda J;Bustraan, Sophia;Hills, Robert K;Ali, Akbar;Goldstone, Anthony H;Burnett, Alan K;Linch, David C;Gale, Rosemary E
Keywords: Aged;Aged, 80 and over;CCAAT-Enhancer-Binding Proteins;Female;Genotype;Humans;Kaplan-Meier Estimate;Leukemia, Myeloid, Acute;Male;Middle Aged;Mutation;Nuclear Proteins;Prognosis;Risk Assessment;Risk Factors;Treatment Outcome;fms-Like Tyrosine Kinase 3;gen
Issue Date: 2016
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 (CEBPA(DM) ) 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 CEBPA(DM) compared to the 76 (28%) with a mutant NPM1 and wild-type FLT3 (NPM1(MUT) FLT3(WT) ) 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 CEBPA(DM) and NPM1(MUT) FLT3(WT) 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.
Appears in Collections:Oncology

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