Work

Retrospective study on the clinical outcomes and characteristics of acute myeloid leukemia: different outcomes in the same risk group

Year: 2025

Type: article

Abstract: Background Acute myeloid leukemia (AML) remains a prognostically heterogeneous malignancy despite advances in molecular risk stratification. While the 2022 European Leukemia Network (ELN) guidelines refine risk classification, their accuracy in predicting survival outcomes across genetic requires validation. Methods We conducted a retrospective analysis of 154 newly diagnosed AML patients at Daping Hospital, integrating next-generation sequencing (NGS)-based genetic profiling, 2022 ELN risk classification, and clinical outcomes. Results The most frequent mutations were FLT3 (26.6%), DNMT3A (21.4%), NPM1 (18.2%), CEBPA (17.5%), and TET2 (15.6%). Median overall survival (OS) and progression-free survival (PFS) were 22.9 months and 14.1 months, respectively. Hematopoietic stem cell transplantation (HSCT), female sex, age < 60 years, and normal karyotype emerged as favorable prognostic factors. No significant differences were observed between allogeneic (allo-HSCT) and autologous HSCT (ASCT). Idarubicin, cytarabine, etoposide (IA ± E) chemotherapy yielded superior survival, while azacitidine+venetoclax (AZA+VEN) regimens underperformed. Conversely, TP53 and KIT mutations correlated with inferior survival, while NPM1, CEBPA mutations predicted longer survival. Notably, significant survival heterogeneity existed within 2022 ELN risk groups, particularly among patients with FLT3 , CEBPA , or TET2 mutations. Conclusions The ELN risk classification demonstrate limitations in prognostication, particularly for patients with FLT3 , CEBPA , or TET2 mutations. Our findings highlight the necessity for refined risk models incorporating additional molecular markers ( KIT ) and mutation interactions to enhance personalized prognostication. Gene coexistence is also a factor that needs to be considered when determining patient prognosis. Trial registration The study was registered on the Chinese clinical trial registry (ChiCTR) platform (No. ChiCTR2500096484).

Source: PeerJ

DOI: 10.7717/peerj.20436

Authors: Fanqiao Meng, Maoyuan Xiang, Huan Xie, Yu Liu, Yan Qi, Dongfeng Zeng

Institutions: Army Medical University, Daping Hospital

Language: English

Topic: Acute Myeloid Leukemia Research

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,395