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Is the Presence of RUNX1 Mutations an Adverse Risk Factor in AML?

By: Joseph Fanelli
Posted: Thursday, July 22, 2021

According to findings presented during the European Hematology Association Virtual Congress (EHA2021; Abstract S132), patients with newly diagnosed acute myeloid leukemia (AML) had comparable outcomes across contemporary treatment regimens when comparing them with mutated RUNX1 and wild-type RUNX1 disease. These similar findings, concluded Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer, Houston, and colleagues, make one question whether RUNX1 mutations should be considered an adverse risk factor for patients with AML.

With venetoclax-based regimens, a median overall survival of more than 2 years was observed in patients with RUNX1-mutated AML,” the authors observed.

In this trial, the authors focused on 907 newly diagnosed patients with AML treated at MD Anderson from 2009 to 2020. The patients were treated with intensive chemotherapy or low-intensity chemotherapy, including hypomethylating agents with and without venetoclax. Among the 907 patients, 137 (15%) had mutated RUNX1. In addition, the investigators reported that patients with RUNX1-mutated AML tended to be older than those with wild-type disease, were more likely to have secondary AML (20% vs. 13%, respectively), and were less likely to have adverse-risk cytogenetics (20% vs. 34%, respectively).

Of the patients with RUNX1 mutations, 35 received intensive chemotherapy (26%), 66 received low-intensive chemotherapy without venetoclax (48%), and 36 were given low-intensive chemotherapy with venetoclax (26%). Response rates were similar for patients with mutated RUNX1 and wild-type RUNX1 for intensive chemotherapy (77% vs. 80%, respectively), low-intensive chemotherapy without venetoclax (44% vs. 52%, respectively), and low-intensive chemotherapy with venetoclax (72% vs. 73%).

Similarly, overall survival rates between the two groups were comparable for patients younger than age 60, and RUNX1 mutations did not seem to impact overall survival in those treated with intensive chemotherapy or with low-intensive chemotherapy without venetoclax.

Disclosure: For full disclosure of the study authors, visit library.ehaweb.org.



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