Normal karyotype acute myeloid leukemia patients with CEBPA double mutation have a favorable prognosis but no survival benefit from allogeneic stem cell transplant

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• 作者：Jae-Sook Ahn ; Jae-Young Kim ; Hyeoung-Joon Kim ; Yeo-Kyeoung Kim…
• 关键词：Acute myeloid leukemia ; CEBPA ; Allogeneic hematopoietic cell transplantation ; Chemotherapy
• 刊名：Annals of Hematology
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：95
• 期：2
• 页码：301-310
• 全文大小：703 KB
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• 作者单位：Jae-Sook Ahn (1)
  Jae-Young Kim (1)
  Hyeoung-Joon Kim (1)
  Yeo-Kyeoung Kim (1)
  Seung-Shin Lee (1)
  Sung-Hoon Jung (1)
  Deok-Hwan Yang (1)
  Je-Jung Lee (1)
  Nan Young Kim (2)
  Seung Hyun Choi (2)
  Mark D. Minden (3)
  Chul Won Jung (4)
  Jun-Ho Jang (4)
  Hee Je Kim (5)
  Joon Ho Moon (6)
  Sang Kyun Sohn (6)
  Jong-Ho Won (7)
  Sung-Hyun Kim (8)
  Dennis Dong Hwan Kim (3)
  
  1. Department of Hematology-Oncology, Chonnam National University Hwasun Hospital, 322 Seoyangro, Hwasun, Jeollanamdo, 519-763, Republic of Korea
  2. Genomic Research Center for Hematopoietic Diseases, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Republic of Korea
  3. Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
  4. Division of Hematology-Oncology, Samsung Medical Center, Seoul, South Korea
  5. Department of Hematology, Cancer Research Institute, Seoul St. Mary’s Hospital, Colllege of Medicine, The Catholic University of Korea, Seoul, South Korea
  6. Department of Hematology-Oncology, Kyungpook National University Hospital, Daegu, South Korea
  7. Department of Hematology-Oncology, Soon Chun Hyang University Hospital, Seoul, South Korea
  8. Department of Hematology-Oncology, Dong-A University College of Medicine, Busan, South Korea
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Hematology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1432-0584

文摘

Normal karyotype acute myeloid leukemia (NK-AML) with CCAAT/enhancer binding protein α (CEBPA) mutations is known to have a more favorable prognosis. However, direct comparison of the clinical significance according to consolidation therapy has not been widely performed in patients with NK-AML. A total of 404 patients with NK-AML who received intensive induction chemotherapy were included in the present study. Diagnostic samples from the patients were evaluated for CEBPA mutations by direct sequencing. CEBPA single (sm) or double mutation (dm) was observed in 27 (6.7 %) and 51 (12.6 %) patients, respectively. CEBPA dm was associated with GATA2 mut, and it was less frequently associated with FLT3-ITDpos, NPM1 mut, and DNMT3A mut in comparison with CEBPA wild or CEBPA sm (all p values <0.05). On multivariate analysis, CEBPA dm (p = 0.007, OR 39.593) was an independent risk factor for achievement of complete remission (CR). With a median follow-up of 40.1 months, CEBPA dm showed a favorable overall survival (OS), event-free survival (EFS), and lower relapse incidence (RI) in comparison with CEBPA wild (all p values <0.005). Comparison of clinical outcome analyses (consolidation chemotherapy vs. allogeneic hematopoietic cell transplantation (HCT)) demonstrated the role of consolidation treatment in patients with CEBPA dm. Allogeneic HCT was associated with lower EFS and RI and a trend of higher non-relapse mortality. However, there was no statistically significant difference in OS. In conclusion, CEBPA dm was associated with other molecular mutations. Consolidation chemotherapy alone may overcome higher relapse rates by reducing the treatment mortality and increasing survival after relapse events in patients with CEBPA dm in NK-AML.