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. 2025 Sep;175(11-12):274-281.
doi: 10.1007/s10354-025-01099-3. Epub 2025 Jul 22.

Features of KRAS-mutated patients with chronic myelomonocytic leukemia with and without blast transformation in a national (ABCMML) and international cohort (BIOPORTAL)

Melanie Weissenbacher  1 , Klaus Geissler  2
Affiliations

Features of KRAS-mutated patients with chronic myelomonocytic leukemia with and without blast transformation in a national (ABCMML) and international cohort (BIOPORTAL)

Melanie Weissenbacher et al. Wien Med Wochenschr. 2025 Sep.

Abstract
in English, German

Big data collected in large international cooperations nowadays allow validation of findings from traditional national patient cohorts for proving consistency. In this study we compared findings in KRAS-mutated patients of the Austrian biodatabase for chronic myelomonocytic leukemia (ABCMML) with that from the CMML cohort documented in cBioPortal. It was consistently shown in both CMML cohorts that KRAS mutations were not associated with shorter overall and acute myeloid leukemia (AML)-free survival. In both cohorts, phenotypic features such as leukocytes, hemoglobin, and circulating blasts were not significantly different between patients with and without KRAS mutations. However, the proportion of patients with thrombocytopenia was higher in KRAS-mutated patients in the BIOPORTAL cohort but not in the ABCMML cohort. The percentage of KRAS mutations significantly increased in blast transformation (from 9.8 to 21.7%), as shown in the ABCMML cohort. These data may suggest a pathogenetic role of KRAS mutations in CMML-associated AML.

Große Datenmengen aus internationalen Kooperationen ermöglichen die Validierung nationaler Patientenkohorten zur Überprüfung der Konsistenz von Daten. In dieser Studie verglichen wir die Ergebnisse von Patienten mit KRAS-Mutation der nationalen „Austrian Biodatabase for chronic myelomonocytic leukemia“ (ABCMML) mit Patienten der internationalen Plattform cBioPortal. Es kann in beiden Kohorten mit chronischer myelomonozytärer Leukämie (CMML) übereinstimmend gezeigt werden, dass KRAS-Mutationen nicht mit einem schlechteren Gesamtüberleben und von akuter myeloischer Leukämie (AML) freiem Überleben assoziiert sind. Auch phänotypische Merkmale wie Leukozytenzahl, Hämoglobin und zirkulierende Blasten waren in beiden Kohorten nicht unterschiedlich. Der Anteil von Patienten mit Thrombozytopenie bei Patienten mit KRAS-Mutation war in der BIOPORTAL-Kohorte, allerdings nicht in der ABCMML-Kohorte erhöht. Der Prozentsatz von KRAS-Mutationen stieg, wie in der ABCMML-Kohorte gezeigt werden konnte, signifikant in der Blastentransformation an (von 9,8 auf 21,7 %). Diese Daten lassen eine pathogenetische Rolle der KRAS-Mutation bei CMML-assoziierter AML vermuten.

Keywords: KRAS; Acute myeloid leukemia; Austrian biodatabase for chronic myelomonocytic leukemia; BIOPORTAL; Chronic myelomonocytic leukemia.

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Conflict of interest statement

Conflict of interest: M. Weissenbacher and K. Geissler declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Kaplan–Meier plots for overall survival in CMML patients with and without KRAS mutations
Fig. 2
Fig. 2
Kaplan–Meier plots for AML-free survival in CMML patients with and without KRAS mutations
Fig. 3
Fig. 3
Boxplots showing the distribution of leukocytes in KRAS-nonmutated and KRAS-mutated CMML patients including median values, minimum values, maximum values, and upper and lower quartiles in both study cohorts
Fig. 4
Fig. 4
Boxplots showing the distribution of hemoglobin values in KRAS-nonmutated and KRAS-mutated CMML patients including median values, minimum values, maximum values, and upper and lower quartiles in both study cohorts
Fig. 5
Fig. 5
Boxplots showing the distribution of platelets in KRAS-nonmutated and KRAS-mutated CMML patients including median values, minimum values, maximum values, and upper and lower quartiles in both study cohorts
Fig. 6
Fig. 6
Kaplan–Meier plots for overall survival in patients with CMML-associated AML with and without KRAS mutations
See this image and copyright information in PMC

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