%0 Journal Article
%T Mutational spectrum and prognostic stratification of intermediate-risk acute myeloid leukemia
%J -
%D 2018
%R https://doi.org/10.1038/s41417-018-0028-z
%X The mutational spectrum and prognostic stratification of intermediate-risk acute myeloid leukemia (IR-AML), which accounts for a substantial number of AML, are unclear. In order to explore the prognostic significance of the mutational spectrum in IR-AML, 106 IR-AML patients were collected from The Cancer Genome Atlas database. Sixty-two patients underwent chemotherapy-only, forty-four proceeded to allogeneic hematopoietic stem cell transplantation (allo-HSCT). Fifty-five patients had more than five recurrent genetic mutations. NPM1 had the highest mutation frequency, followed by DNMT3A, FLT3, RUNX1, IDH2, IDH1, and TET2. In all patients, allo-HSCT was an independent favorable factor for EFS and OS (P£¿=£¿0.036, P£¿=£¿0.001, respectively); age ¡Ý60 years, FLT3-ITD and mutations in DNMT3A and RUNX1 were independent risk factors for survival (all P£¿<£¿0.05). In the chemotherapy-only group, multivariate analysis showed that age ¡Ý60 years was an independent risk factor for EFS and OS (P£¿=£¿0.008, P£¿=£¿0.017, respectively). In the allo-HSCT group, multivariate analysis indicated that MLL-PTD was an independent risk fact for EFS (P£¿=£¿0.037), FLT3-ITD and RUNX1 mutations independently contributed to poor OS (P£¿=£¿0.035, P£¿=£¿0.014, respectively). In conclusion, older age was an important risk factor for IR-AML patients undergoing chemotherapy-only; FLT3-ITD, MLL-PTD and RUNX1 mutations were significant risk factors for IR-AML patients who received allo-HSCT
%U https://www.nature.com/articles/s41417-018-0028-z