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. 2018 Feb;107(2):201-210.
doi: 10.1007/s12185-017-2340-z. Epub 2017 Oct 12.

Prognostic value of genetic mutations in adolescent and young adults with acute myeloid leukemia

Yachiyo Kuwatsuka  1 , Daisuke Tomizawa  2 , Rika Kihara  3 , Yasunobu Nagata  4 , Norio Shiba  5 , Yuka Iijima-Yamashita  6 , Akira Shimada  7 , Takao Deguchi  8 , Hayato Miyachi  9 , Akio Tawa  10 , Takashi Taga  11 , Akitoshi Kinoshita  12 , Hideki Nakayama  13 , Nobutaka Kiyokawa  14 , Akiko Moriya Saito  6 , Katsuyoshi Koh  15 , Hiroaki Goto  16 , Yoshiyuki Kosaka  17 , Norio Asou  18 , Shigeki Ohtake  19 , Shuichi Miyawaki  20 , Yasushi Miyazaki  21 , Toru Sakura  22 , Yukiyasu Ozawa  23 , Noriko Usui  24 , Heiwa Kanamori  25 , Yoshikazu Ito  26 , Kiyotoshi Imai  27 , Youko Suehiro  28 , Shinichi Kobayashi  29 , Kunio Kitamura  30 , Emiko Sakaida  31 , Seishi Ogawa  32   33 , Tomoki Naoe  3   34 , Yasuhide Hayashi  35 , Keizo Horibe  6 , Atsushi Manabe  36 , Shuki Mizutani  37 , Souichi Adachi  38 , Hitoshi Kiyoi  3
Affiliations
Free article

Prognostic value of genetic mutations in adolescent and young adults with acute myeloid leukemia

Yachiyo Kuwatsuka et al. Int J Hematol. 2018 Feb.
Free article

Abstract

Clinical outcomes and the genetic background of acute myeloid leukemia (AML) in adolescent and young adults (AYAs) are known to differ in younger children and older adults. To clarify the impact of genetic mutations on clinical outcomes of AYAs with AML, we analyzed data from the JPLSG AML-05 and JALSG AML201 studies. AYAs aged 15-39 years (n = 103) were included. FLT3-ITD, KIT, CEBPA, NRAS, KRAS, WT1, MLL-PTD, and NPM1 mutations were analyzed. Overall survival (OS) of the AYAs was 61% and event-free survival was 38% at 3 years. FLT3-ITD (HR 2.10; 95% CI 1.07-4.12; p = 0.031) and NPM1 (HR 0.24; 95% CI 0.06-1.00; p = 0.050) mutations were associated with risk of overall mortality in multivariate analysis. OS was significantly different according to FLT3-ITD and NPM1 mutation status (p = 0.03). Survival was 100% with NPM1 mutations in the absence of FLT3-ITD and 35% (95% CI 14-57%) with FLT3-ITD in the absence of NPM1 mutations. The OS of AYAs, children (n = 413) and older adults (n = 124) of the AML-05 and AML201 participants were significantly different (p < 0.0001). This is the first report to combine clinical and genetic data of AYA AML from the major Japanese pediatric and adult study groups.

Keywords: AML; AYA; Genetic mutation; Prognosis.

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