Clinical characteristics and prognostic study of adult acute myeloid leukemia patients with ASXL1 mutations

摘要

Objectives : A total of 156 adult acute myeloid leukemia (AML) patients were enrolled in this study to explore the clinical characteristics and prognostic impact of ASXL1 mutations. Methods : Clinical characteristics, prognostic impact and the association between ASXL1 mutations and some other mutations were analyzed. Results : We found ASXL1 mutations were most frequently found in M5 subtype and intermediate risk karyotype and were correlated with TET2 , DNMT3A and PHF6 mutations. A total of 145 patients were included in prognostic analysis; results showed ASXL1 mutations had no impact on OS and DFS. In normal karyotype-AML (CN-AML) and older (≥60 years) AML, ASXL1 mutations showed adverse impact on OS ( P =?0.022; p =?0.019, respectively) and showed adverse prognostic tendency on DFS ( p =?0.173; p =?0.108, respectively). ASXL1 mutations were also independent unfavourable prognostic factors for OS on CN-AML and older (≥60 years) AML patients and unfavourable factors for DFS on older (≥60 years) AML in multivariate analysis. Results also indicated that though ASXL1 mutations were associated with TET2 , DNMT3A and PHF6 mutations, when coinciding with ASXL1 mutations, the prognosis of AML was not significantly impacted. Discussion : The reliability of our results need to be further confirmed by prospective randomized controlled studies covering a large numbers of AML patients. Conclusion : The results showed ASXL1 mutations may act as a poor prognostic index especially in elder AML and CN-AML patients.