Clinical characteristics and prognostic study of adult acute myeloid leukemia patients with ASXL1 mutations

ABSTRACT

Objectives: A total of 156 adult acute myeloid leukemia (AML) patients were enrolled in this study to explore the clinical characteristics and prognostic impact of ASXL1 mutations. Methods: Clinical characteristics, prognostic impact and the association between ASXL1 mutations and some other mutations were analyzed. Results: We found ASXL1 mutations were most frequently found in M5 subtype and intermediate risk karyotype and were correlated with TET2, DNMT3A and PHF6 mutations. A total of 145 patients were included in prognostic analysis; results showed ASXL1 mutations had no impact on OS and DFS. In normal karyotype-AML (CN-AML) and older (≥60 years) AML, ASXL1 mutations showed adverse impact on OS (P = 0.022; p = 0.019, respectively) and showed adverse prognostic tendency on DFS (p = 0.173; p = 0.108, respectively). ASXL1 mutations were also independent unfavourable prognostic factors for OS on CN-AML and older (≥60 years) AML patients and unfavourable factors for DFS on older (≥60 years) AML in multivariate analysis. Results also indicated that though ASXL1 mutations were associated with TET2, DNMT3A and PHF6 mutations, when coinciding with ASXL1 mutations, the prognosis of AML was not significantly impacted. Discussion: The reliability of our results need to be further confirmed by prospective randomized controlled studies covering a large numbers of AML patients. Conclusion: The results showed ASXL1 mutations may act as a poor prognostic index especially in elder AML and CN-AML patients.

KEYWORDS:

• Acute myeloid leukemia
• ASXL1 mutations
• clinical characteristic
• prognosis

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

*The P-value of the total distribution in FAB classification when compared ASXL1 mutation group with wild-type group.

^a The P-value of the total distribution in karyotype when compared ASXL1 mutation group with wild-type group.

^b The P-value of the normal karyotype and abnormal karyotype when compared ASXL1 mutation group with wild type-group.

^a Take the median value as the cut-off point.

Additional information

Funding

This work was supported by National Natural Science Foundation of China [grant numbers 81770163, Œ81270609, 81470008, 815001]; The National and Fujian Provincial Key Clinical Specialty Discipline Construction Program [grant number 2011-1006, 2012-149]; Construction Project of Fujian Medical Center of Hematology [grant number Min201704]; Fujian Province Health Education Joint Research Project [grant number WKJ-2016-2-07]; Special Funding of Fujian Provincial Department of Finance [grant number Min2017-655].