MECOM gene overexpression in pediatric patients with acute myeloid leukemia

Figures & data

Figure 1. Prevalence of MECOM overexpression gene among pediatric patients with AML.

Table 1. Distribution of MECOM gene overexpression depending on patient’s characteristics with multiple hypothesis adjustment.

	MECOM gene overexpression		p Value
	Yes (total = 53 cases)	No (total = 162 cases)
	N(%)	N(%)
Age (median)			.042^a
<7.2 years	35 (66%)	71 (43.8%)
≥7.2 years	18 (33.9%)	91 (56.1%)
Initial TLC (median)			1
<20.6	24 (45.2%)	82 (50.6%)
≥20.6	20 (37.7%)	89 (54.9%)
FAB Classification			.014^a
0	8 (13.2%)	9 (5.6%)
1	3 (5.7%)	25 (15.4%)
2	6 (11.3%)	83 (51.2%)
4	8 (15.1%)	28 (17.3%)
5	9 (17.0%)	10 (6.2%)
6	4 (7.5%)	0 (0.0%)
7	15 (28.3%)	7 (4.3%)
MLL-rearrangement			.014^a
Negative	41 (77.4%)	152 (93.8%)
Positive	12 (22.6%)	10 (6.2%)
Trisomy 8			.154
No	41 (77.4%)	147 (90.7%)
Yes	12 (22.6%)	15 (9.3%)
Trisomy 21			.168
No	46 (86.8%)	156 (96.3%)
Yes	7 (13.2%)	6 (3.7%)
Monosomy 7			.154
No	48 (90.6%)	159 (98.1%)
Yes	5 (9.4%)	3 (1.9%)
Complex Karyotype			.014^a
No	43 (81.1%)	158 (97.5%)
Yes	10 (18.9%)	4 (2.5%)
FLT3/ITDs			1
Mutant (< 0.4 AR)	0 (0.0%)	1 (.6%)
Mutant (> = 0.4 AR)	1 (1.9%)	12 (7.4%)
Wild type	52 (98.2%)	149 (92%)
Initial risk			.014^a
High Risk	16 (30.2%)	20 (12.3%)
Intermediate risk	35 (66%)	78 (48.1%)
Low risk	2 (3.8%)	64 (39.5%)

^aStatistically significant.

TLC: total leukocyte count (TLC); FAB: French-American-British classification; MLL: mixed Lineage leukemia; ITDs: internal tandem duplications; AR: Allelic Ratio.

Figure 2. Impact of MECOM gene overexpression on survival. (A) Kaplan–Meier curves of overall survival of patients with MECOM^pos vs MECOM^neg among the whole cohort, (B) Kaplan–Meier curves of event-free survival of patients with with MECOM^pos vs MECOM^neg among the whole cohort, (C) Cumulative incidence of relapse among patients with MECOM^pos vs MECOM^neg among the whole cohort, (D) Kaplan–Meier curves of overall survival of patients with MECOM^pos vs MECOM^neg within disease risk group, (E) Kaplan–Meier curves of event-free survival of patients with MECOM^pos vs MECOM^neg within disease risk group.

Table 2. Cox regression for univariate and multivariate analyses of MECOM overexpression, FAB, MLL-r, complex karyotype, and initial risk.

OS	Univariate			Multivariate
	Hazards Ratio	95%CI for HR Lower– Upper	p Value	Hazards Ratio	95%CI for HR Lower –Upper	p Value
MECOM gene overexpression	3.48	2.13–5.68	<.001	2.11	1.24–1.24	.006
FAB (M7 vs. others)	1.57	0.78–3.19	.208
MLL_gene	1.99	1.04–3.81	.038	1.33	0.67–2.63	.419
Complex Karyotype	3.78	1.92–7.45	<.001	1.02	0.43–2.39	.970
Initial Risk			<.001			<.001
Low	1(–)	1(–)		1(–)	1(–)
Intermediate	5.38	2.11—13.81		3.89	1.47—10.31
High	13.17	4.98—34.81		9.41	3.29—26.9
EFS	Univariate			Multivariate
	Hazards Ratio	95%CI for HR Lower – Upper	p Value	Hazards Ratio	95%CI for HR Lower –Upper	p Value
MECOM gene overexpression	2.58	1.67–3.99	<.001	1.72	1.07–2.76	.025
FAB (M7 vs. others)	1.39	0.74–2.61	.314
MLL_gene	1.52	0.83–2.80	.177	1.05	0.55–1.99	.878
Complex Karyotype	2.84	1.46–5.51	.002	1.01	0.436–2.33	.983
Initial Risk			<.001			<.001
Low	1(–)	1(–)		1(–)	1(–)
Intermediate	3.80	1.93–7.49		3.16	1.56–6.42
High	7.23	3.45–15.18		5.82	2.55–13.27

EFS: event-free survival; OS: overall survival; CI: confidence interval: HR: hazards ratio.

Figure 3. MECOM overexpression among patients in the intermediate risk group.