Yu Shunjie, Hu Lijuan, Qin Yazhen, Ruan Guorui, Wang Yazhe, Jiang Hao, Tang Feifei, Zhao Ting, Jia Jinsong, Wang Jing, Fu Qiang, Zhang Xiaohui, Xu Lanping, Wang Yu, Sun Yuqian, Lai Yueyun, Shi Hongxia, Huang Xiaojun, Jiang Qian
Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University, Beijing 100871, China.
Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
Cancers (Basel). 2025 Jul 29;17(15):2494. doi: 10.3390/cancers17152494.
CCAAT/enhancer-binding protein alpha-basic leucine zipper in-frame () mutations are associated with favorable outcomes in acute myeloid leukemia (AML). So far, there are limited data on integrating clinical and genomic features impacting the outcomes. Clinical and genomic data from consecutive patients with were reviewed. A Cox proportional hazards regression was used to identify the variables associated with event-free survival (EFS), relapse-free survival (RFS) and survival. 224 patients were included in this study. In the 201 patients, except for the 19 receiving the transplant in the first complete remission with no events (the transplant cohort), multivariate analyses showed that mutations/deletions were significantly associated with poor EFS ( = 0.001) and RFS ( < 0.001); -ITD mutations, poor RFS ( = 0.048). In addition, increasing WBC count, lower hemoglobin concentration, non-intensive induction, and MRD positivity after first consolidation predicted poor outcomes. On the basis of the number of adverse prognostic covariates for RFS, the 201 patients were classified into low-, intermediate- or high-risk subgroups, and there were significant differences in the 3-year EFS, RFS and survival rates (all < 0.001); however, except for survival in the low-risk group, these metrics were lower than those in the transplant cohort. We identified a potential high-risk population with adverse prognostic factors in AML patients for which transplantation should be considered.
CCAAT/增强子结合蛋白α-碱性亮氨酸拉链框内（）突变与急性髓系白血病（AML）的良好预后相关。到目前为止，关于整合影响预后的临床和基因组特征的数据有限。回顾了连续的 患者的临床和基因组数据。使用Cox比例风险回归来确定与无事件生存（EFS）、无复发生存（RFS）和总生存相关的变量。本研究纳入了224例患者。在201例患者中，除了19例在首次完全缓解时接受移植且无事件发生的患者（移植队列）外，多因素分析显示， 突变/缺失与较差的EFS（ = 0.001）和RFS（ < 0.001）显著相关；-ITD突变与较差的RFS（ = 0.048）相关。此外，白细胞计数增加、血红蛋白浓度降低、非强化诱导以及首次巩固后微小残留病阳性预示着预后不良。根据RFS的不良预后协变量数量，将201例患者分为低、中或高风险亚组，3年EFS、RFS和总生存率存在显著差异（均 < 0.001）；然而，除了低风险组的总生存率外，这些指标均低于移植队列。我们在AML患者中识别出了一个具有不良预后因素的潜在高风险人群，对此应考虑进行移植。
