Allogeneic hematopoietic stem cell transplantation could improve the survival of acute myeloid leukemia patients with ASXL1 mutations

被引：8
作者：
Zhou, Lili [1 ,2 ]
An, Jingnan [1 ,2 ]
Hou, Chang [1 ]
Ding, Zixuan [1 ]
Qiu, Huiying [1 ]
Tang, Xiaowen [1 ]
Sun, Aining [1 ]
Chen, Suning [1 ]
Xu, Yang [1 ,2 ]
Liu, Tianhui [1 ,2 ]
Wu, Depei [1 ,2 ]
机构：
[1] Soochow Univ, Natl Clin Res Ctr Hematol Dis, Jiangsu Inst Hematol, Affiliated Hosp 1, Suzhou, Peoples R China
[2] Soochow Univ, Collaborat Innovat Ctr Hematol, Inst Blood & Marrow Transplantat, Suzhou, Peoples R China
来源：
HEMATOLOGY | 2021年 / 26卷 / 01期
基金：
中国国家自然科学基金;
关键词：
Acute myeloid leukemia; allogeneic hematopoietic stem cell transplant; ASXL1; mutation;
D O I：
10.1080/16078454.2021.1905356
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Objective: To discover the function of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in ASXL1-mutated acute myeloid leukemia (AML) patients. Methods: We analyzed the prognostic value of ASXL1 mutations and explored the role of allo-HSCT in 581 AML patients. Results: According to the definition of intermediate- and adverse-risk AML groups in the European Leukemia Net (ELN), ASXL1-mutated patients had shorter OS and DFS than ASXL1-wild-type patients in the intermediate- and adverse-risk AML groups (3-year OS: 47.5% vs. 60.8%, P<0.001; 3-year DFS: 28.5% vs. 48.9%, P<0.001). Among the cytogenetically normal acute myeloid leukemia (CN-AML), differences were found in both OS (47.4% vs.65.2%, P<0.001) and DFS (21.0% vs. 52.1%, P<0.001) between ASXL1-mutated patients and ASXL1 wild-type patients. In the ASXL1-mutated AML cohort, the patients received allo-HSCT had longer 3-year OS (P=0.0005) and 3-year DFS (P<0.0001) than those who did not receive allo-HSCT. Multivariate analysis revealed that ASXL1 mutation was an independent prognostic factor for OS (HR 2.248, 95% CI 1.155-4.375, P=0.017), and allo-HSCT had a positive impact on OS (HR 7.568, 95% CI 3.597-15.92, P<0.001) and DFS (HR 2.611, 95% CI 1.688-4.039, P<0.001) in ASXL1-mutated patients. Conclusion: The results indicate that the presence of ASXL1 mutations is a factor predictive of poor prognosis in AML patients and allo-HSCT could improve the survival of AML patients with ASXL1 mutations.
引用
收藏
页码：340 / 347
页数：8
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