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Rebecca Olin, MD, MS


Gene Mutations and Survival Outcomes in Older Patients With AML

By: Kayci Reyer
Posted: Tuesday, November 10, 2020

According to research published in the International Journal of Laboratory Hematology, the development of a mutation profile for older patients with acute myeloid leukemia (AML) may help determine the likely benefit of decitabine-based chemotherapy. Zeng et al, of the First Affiliated Hospital of Anhui Medical University, China, and colleagues focused their research on the correlation between gene mutations and treatment outcomes.

Conducted between December 2016 and December 2019, the study included 92 patients between the ages of 60 and 75 and 116 patients younger than age 60, all of whom had been diagnosed with de novo AML. Next-generation sequencing was used to identify gene mutations in bone marrow samples. All patients aged 60 and older received decitabine therapy in conjunction with priming regimens. Patients younger than age 60 received standard 3 + 7 chemotherapy, with 26 younger patients also receiving allogeneic hematopoietic stem cell transplantation.

Gene mutations were identified more commonly in the older age group, specifically DNMT3A, IDH2, ASXL1, TET2, RUNX1, CEBPA single mutation, and TP53 mutations. Although an association between DNMT3A, FLT3-ITD, and TP53 mutations and worsened overall and event-free survival outcomes was noted in the younger age group, the same poor prognostic association was present only in patients with FLT3-ITD and ASXL1 mutations and who were treated with decitabine. Such an association was not noted in that group for patients with DNMT3A and TP53 mutations. A CEBPA single mutation was determined to be an unfavorable prognostic favorable, unlike a CEBPA double mutation.

Disclosure: The study authors reported no conflicts of interest.

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