J 2022

Molecular profiling and clinical implications of patients with acute myeloid leukemia and extramedullary manifestations

ECKARDT, J. N., F. STOLZEL, D. KUNADT, C. ROLLIG, S. STASIK et. al.

Základní údaje

Originální název

Molecular profiling and clinical implications of patients with acute myeloid leukemia and extramedullary manifestations

Autoři

ECKARDT, J. N. (garant), F. STOLZEL, D. KUNADT, C. ROLLIG, S. STASIK, L. WAGENFUHR, K. JOHRENS, F. KUITHAN, A. KRAMER, S. SCHOLL, A. HOCHHAUS, M. CRYSANDT, T. H. BRUMMENDORF, R. NAUMANN, B. STEFFEN, V. KUNZMANN, H. EINSELE, M. SCHAICH, A. BURCHERT, A. NEUBAUER, K. SCHAFER ECKART, C. SCHLIEMANN, S. W. KRAUSE, R. HERBST, M. HANEL, M. HANOUN, U. KAISER, M. KAUFMANN, Zdeněk RÁČIL (203 Česká republika, domácí), Jiří MAYER (203 Česká republika, domácí), F. KROSCHINSKY, W. E. BERDEL, G. EHNINGER, H. SERVE, C. MULLER TIDOW, U. PLATZBECKER, C. D. BALDUS, J. SCHETELIG, M. BORNHAUSER, C. THIEDE a J. M. MIDDEKE

Vydání

JOURNAL OF HEMATOLOGY & ONCOLOGY, LONDON, BMC, 2022, 1756-8722

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30205 Hematology

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 28.500

Kód RIV

RIV/00216224:14110/22:00126253

Organizační jednotka

Lékařská fakulta

UT WoS

000795132900001

Klíčová slova anglicky

Acute myeloid leukemia; Extramedullary; Leukemia cutis; Chloroma; Myeloid sarcoma

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 14. 7. 2022 09:00, Mgr. Tereza Miškechová

Anotace

V originále

Background Extramedullary manifestations (EM) are rare in acute myeloid leukemia (AML) and their impact on clinical outcomes is controversially discussed. Methods We retrospectively analyzed a large multi-center cohort of 1583 newly diagnosed AML patients, of whom 225 (14.21%) had EM. Results AML patients with EM presented with significantly higher counts of white blood cells (p < 0.0001), peripheral blood blasts (p < 0.0001), bone marrow blasts (p = 0.019), and LDH (p < 0.0001). Regarding molecular genetics, EM AML was associated with mutations of NPM1 (OR: 1.66, p < 0.001), FLT3-ITD (OR: 1.72, p < 0.001) and PTPN11 (OR: 2.46, p < 0.001). With regard to clinical outcomes, EM AML patients were less likely to achieve complete remissions (OR: 0.62, p = 0.004), and had a higher early death rate (OR: 2.23, p = 0.003). Multivariable analysis revealed EM as an independent risk factor for reduced overall survival (hazard ratio [HR]: 1.43, p < 0.001), however, for patients who received allogeneic hematopoietic cell transplantation (HCT) survival did not differ. For patients bearing EM AML, multivariable analysis unveiled mutated TP53 and IKZF1 as independent risk factors for reduced event-free (HR: 4.45, p < 0.001, and HR: 2.05, p = 0.044, respectively) and overall survival (HR: 2.48, p = 0.026, and HR: 2.63, p = 0.008, respectively). Conclusion Our analysis represents one of the largest cohorts of EM AML and establishes key molecular markers linked to EM, providing new evidence that EM is associated with adverse risk in AML and may warrant allogeneic HCT in eligible patients with EM.