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Published on: March 26, 2018
[Clinical Characteristics and Prognosis of Acute Myeloid Leukemia Patients with inv(16)/t(16;16)(p13.1;q22) and/or
Ye-Min Wang1, Ping Cai1, Mei-Jia Zhou1
1Department of Hematology, The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, Jiangsu Province, China.
Objective:
To summarize the clinical and laboratory characteristics of patients with acute myeloid leukemia (AML) with inv(16)/t(16;16) (p13.1;q22), and to analyze the risk factors affecting the prognosis of the patients.
Methods:
AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11+ admitted to the Department of Hematology, The First Affiliated Hospital of Soochow University from January 1, 2008 to October 30, 2019 were retrospective analyzed, the clinical and laboratory indicators, as well as treatment plans and efficacy evaluations of the patients were all recorded. Furthermore, related factors affecting the overall survival (OS) and event-free survival (EFS) of the patients were analyzed.
Results:
Among 151 AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11+, the percentage of additional chromosomal abnormalities was about 27.8%, and the most common additional chromosomal abnormality was +22 (33/151, 21.8%), followed by +8 (11/151, 7.3%). There were 112 patients with perfect NGS examination, and the result showed the most common accompanying gene mutations were KIT mutation (34/112, 30.4%) and FLT3 mutation (23/112, 20.5%). Univariate analysis showed that factors affecting EFS included: NE≤0.5×109/L (P=0.006) and combined K-RAS mutation (P=0.002); Factors affecting OS included: Age≥50 years old (P<0.001) and NE≤0.5×109/L (P=0.016). Multivariate analysis showed that NE≤0.5×109/L (P=0.019) was the risk factors affecting OS. The proportion of bone marrow eosinophilia (BME)≥10.00% (P=0.029) was the risk factors affecting EFS.
Conclusion:
The prognosis for those newly diagnosed AML patients who were of advanced age, the high proportion of bone marrow eosinophils, K-RAS mutations, and agranulocytosis is poor. The treatment plans can be adjusted in the early stage to improve the prognosis of such patients.
Insights
Patients with acute myeloid leukemia (AML) with inv(16)/t(16;16) and specific genetic mutations face poorer prognoses. Early treatment adjustments for factors like age, bone marrow eosinophilia, K-RAS mutations, and agranulocytosis can improve outcomes.
Area of Science:
- Hematology
- Oncology
- Genetics
Background:
- Acute myeloid leukemia (AML) with inv(16)/t(16;16) is a distinct subtype.
- Understanding prognostic factors is crucial for patient management.
Purpose of the Study:
- To summarize clinical and laboratory features of AML patients with inv(16)/t(16;16).
- To identify risk factors influencing prognosis in these patients.
Main Methods:
- Retrospective analysis of 151 AML patients with inv(16)/t(16;16) or CBFβ-MYH11.
- Clinical data, laboratory indicators, and treatment outcomes were recorded.
- Analysis of factors affecting overall survival (OS) and event-free survival (EFS).
Main Results:
- 27.8% of patients had additional chromosomal abnormalities, most commonly +22.
- KIT (30.4%) and FLT3 (20.5%) mutations were frequent.
- Risk factors for poor OS included age ≥50 and low neutrophil count (NE ≤0.5×10⁹/L).
- Risk factors for poor EFS included NE ≤0.5×10⁹/L and K-RAS mutation; high bone marrow eosinophilia (BME ≥10.00%) also impacted EFS.
Conclusions:
- Advanced age, high bone marrow eosinophilia, K-RAS mutations, and agranulocytosis are associated with poor prognosis in newly diagnosed AML patients with inv(16)/t(16;16).
- Early treatment adjustments based on these factors may improve patient outcomes.
