Association Between Mutation Clearance After Induction Therapy and Outcomes in Acute Myeloid Leukemia

诱导治疗后突变清除与急性髓系白血病预后之间的关系

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作者:Jeffery M Klco, Christopher A Miller, Malachi Griffith, Allegra Petti, David H Spencer, Shamika Ketkar-Kulkarni, Lukas D Wartman, Matthew Christopher, Tamara L Lamprecht, Nicole M Helton, Eric J Duncavage, Jacqueline E Payton, Jack Baty, Sharon E Heath, Obi L Griffith, Dong Shen, Jasreet Hundal, Gue

Results

Analysis of comprehensive genomic data from the 71 patients did not improve outcome assessment over current standard-of-care metrics. In an analysis of 50 patients with both presentation and documented remission samples, 24 (48%) had persistent leukemia-associated mutations in at least 5% of bone marrow cells at remission. The 24 with persistent mutations had significantly reduced event-free and overall survival vs the 26 who cleared all mutations. Patients with intermediate cytogenetic risk profiles had similar findings. [table: see text]. Conclusions and relevance: The detection of persistent leukemia-associated mutations in at least 5% of bone marrow cells in day 30 remission samples was associated with a significantly increased risk of relapse, and reduced overall survival. These data suggest that this genomic approach may improve risk stratification for patients with AML.

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