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ETV6突变对急性髓系白血病临床结局的影响:一项真实世界回顾性队列研究。

Impact of ETV6 mutations on clinical outcomes in acute myeloid leukemia: a real-world retrospective cohort study.

作者信息

Li Xueqian, Wang Hong, Han Haohao, Qi Jiaqian, Yao Yifang, Xu Xiaoyan, Pan Tingting, Wu Depei, Han Yue

机构信息

National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China.

Institute of Blood and Marrow Transplantation, Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.

出版信息

Ann Hematol. 2025 Jun 21. doi: 10.1007/s00277-025-06451-6.

Abstract

As a member of the ETS family, ETV6 has been demonstrated to be implicated with the molecular etiology of various hematopoietic diseases. However, the clinical impact of ETV6 mutations (ETV6) in acute myeloid leukemia (AML) remains unclear. Hereon, we included 879 consecutive newly diagnosed AML patients in our institution to elucidate the prognostic impact of ETV6 mutation status. In the overall cohort, ETV6 were found in 24 cases (2.7%) and were associated with lower hemoglobin levels. The predominant common mutation types were missense mutations (15/31, 48.4%) and frameshift mutations (14/31, 45.2%). ETV6 mutations often occurred in conjunction with U2AF1 and ASXL1 mutations. Moreover, ETV6 was associated with a lower complete remission (CR) rate (45.8% vs. 69.1%, P = 0.015) and shorter OS (P = 0.048) compared to the ETV6 wild-type (ETV6) group. Notably, the achievement of CR did not contribute to survival benefit in AML with ETV6. In multivariate analysis, ETV6 mutation was shown to be an independent adverse factor for OS in AML patients (HR: 1.72, 95% CI: 1.03-2.89; P = 0.040). Taken together, our study shows a mutational profile of ETV6 in AML and suggests that ETV6 mutations are associated with poor prognosis in AML patients.

摘要

作为ETS家族的一员,ETV6已被证明与多种血液系统疾病的分子病因有关。然而,ETV6突变(ETV6)在急性髓系白血病(AML)中的临床影响仍不清楚。在此,我们纳入了本机构879例连续新诊断的AML患者,以阐明ETV6突变状态的预后影响。在整个队列中,24例(2.7%)患者检测到ETV6突变,且与较低的血红蛋白水平相关。主要的常见突变类型为错义突变(15/31,48.4%)和移码突变(14/31,45.2%)。ETV6突变常与U2AF1和ASXL1突变同时发生。此外,与ETV6野生型(ETV6)组相比,ETV6突变与较低的完全缓解(CR)率(45.8%对69.1%,P = 0.015)和较短的总生存期(OS)(P = 0.048)相关。值得注意的是,在伴有ETV6突变的AML患者中,达到CR并未带来生存获益。多因素分析显示,ETV6突变是AML患者OS的独立不良因素(HR:1.72,95%CI:1.03 - 2.89;P = 0.040)。综上所述,我们的研究显示了AML中ETV6的突变谱,并提示ETV6突变与AML患者的不良预后相关。

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