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
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.