Clinical characteristics and prognostic analysis of acute myeloid leukemia patients with PTPN11 mutations

Figures & data

Figure 1. Distribution of mutation sites of PTPN11 mutations. The number in the circle represents the number of mutations, with the most commonly mutated loci being E76 (19/99, 19.2%), D61 (16/99, 16.2%), A72 (12/99, 12.1%), G503 (7/99, 7.1%), and S502 (8/99, 8.1%).

Figure 2. Catastrophe distribution waterfall of acute myeloid leukemia (AML) with PTPN11 mutations. DNMT3A mutation rate in PTPN11 mutation-positive AML patients was 29.7% (22/74); the FLT3-ITD mutation rate was 25.6% (19/74), and the NPM1 mutation rate was 32.4% (24/74).

Table 1. Baseline characteristics of PTPN11 mutation-positive acute myeloid leukemia patients.

Characteristics	PTPN11(N = 74)	NO-PTPN11(N = 1101)	P-value
Age (year. range)	43(6–68)	43(3–79)	0.959
Sex (male/female)	35/39	590/511	0.294
WBC (*10^9/L. range)	24.05(1.22–248)	13.33(0.29–584.1)	0.003**
Hemoglobin (g/L. range)	81(35–149)	85(16–165)	0.732
PLT (*10^9/L. range)	60(5–713)	42(1–713)	0.011*
Bone marrow blasts (%)	62.5(13–95)	56(3–99.5)	0.278
Cytogenetics—no.
Normal	44(59.5%)	540(49.0%)	0.083
others	30(40.5%)	456(41.4%)	0.882
No phase	0(0%)	105(9.5%)	0.001**
Fusion gene	17(23.0%)	312(28.3%)	0.320
Mutation			56154
CEBPA	4(5.4%)	142(12.9%)	0.06
FLT3-ITD	19(25.7%)	206(18.7%)	0.136
NPM1	24(32.4%)	117(10.6%)	<0.001**
DNMT3A	22(29.7%)	147(13.4%)	<0.001**
NRAS	20(27.0%)	128(11.6%)	<0.001**
KIT	2(2.7%)	103(9.4%)	0.056
EZH2	2(2.7%)	53(4.8%)	0.073
TET2	6(8.1%)	113(10.3%)	0.558
ASXL1	5(6.8%)	61(5.5%)	0.601

PTPN11: PTPN11 mutation-positive AML patients; NO-PTPN11: PTPN11 mutation-negative AML patients; no. number; WBC: white blood cell counts; PLT: platelet counts.

*p < 0.05.

**p < 0.01.

Table 2. Univariate analysis of the OS analysis in PTPN11 mutations positive AML patients.

Characteristics	N/total(N = 74)	HR (95%CI)	P-value
Age (year. range) <43 >43	37 37	1.497(0.699–3.208)	0.300
Sex (male/female) Female Male	39 35	0.757(0.354–1.620)	0.474
WBC (*10^9/L. range) <24.05 >24.05	36 36	2.594(1.141–5.897)	0.023*
Hemoglobin (g/L. range) <81 >81	36 37	1.746(0.770–3.958)	0.182
PLT (*10^9/L. range) <60 >60	36 37	1.017(0.464–2.231)	0.966
Bone marrow blasts (%) <62.5 >62.5	33 33	2.074(0.905–4.754)	0.085
Cytogenetics—no. Normal others	44 30	1.073(0.502–2.293)	0.856
Fusion gene positive negative	17 57	2.016(0.931–4.366)	0.075
Induction chemotherapy CR NO CR	44 30	0.321(0.150–0.689)	0.004**
Bone marrow transplant YES NO	41 33	0.185(0.082–0.418)	<0.001**
Relapse YES NO	17 57	1.048(0.457–2.404)	0.912
ASXL1 YES NO	5 69	3.393(1.006–11.435)	0.049*
ETV6 YES NO	2 72	58.369(8.053–423.081)	<0.001**
TET2 YES NO	6 68	4.460(1.222–16.276)	0.024*

OS: overall survival; N: number; HR: Hazard Ratio; WBC: white blood cell counts; PLT: platelet counts; no.: number; CR: complete remission; NO CR: no complete remission.

*P < 0.05.

**P < 0.01.

Table 3. Multivariate analysis of the OS analysis in PTPN11 mutations-positive AML patients.

Characteristics	N/total(N = 74)	HR (95%CI)	P-value
WBC (*10^9/L. range) <24.05 >24.05	36 36	4.953(1.517–16.173)	0.008**
Bone marrow blasts (%) <62.5 >62.5	33 33	2.041(0.782–5.326)	0.145
Fusion gene positive negative	17 57	2.835(0.970–8.289)	0.057
Induction chemotherapy CR NO CR	44 30	0.185(0.060–0.573)	0.003**
allo-HSCT YES NO	41 33	0.385(0.148–1.001)	0.050
ASXL1 YES NO	5 69	0.224(0.019–2.688)	0.238
ETV6 YES NO	2 72	15.697(0.857–287.559)	0.063
TET2 YES NO	6 68	9.022(1.683–48.362)	0.010*

OS: overall survival; N: number; HR: Hazard Ratio; WBC: white blood cell counts; PLT: platelet counts; CR: complete remission; NO CR: no complete remission.

*P < 0.05.

**P < 0.01.

Figure 3. Kaplan-Meier overall survival and event free survival curves of acute myeloid leukemia (AML) with PTPN11 mutations showed that the patients who underwent transplantation. A: overall survival; B: event free survival.

Data availability statement

The data that supports the findings of this study are available in the supplementary material of this article.