Clinical Outcomes of Acute Myeloid Leukemia Patients Harboring the RUNX1 Mutation: Is It Still an Unfavorable Prognosis? A Cohort Study and Meta-Analysis

Abstract

Acute myeloid leukemia (AML) with mutated RUNX1 (RUNX1mut) is considered to have an unfavorable prognosis. However, recent studies have reported comparable survival outcomes with wild-type RUNX1 (RUNX1wt). To assess the clinical outcomes of AML with and without RUNX1mut, we performed a prospective cohort study and systematic review and meta-analysis. The study enrolled 135 patients (27 with RUNX1mut; 108 with RUNX1wt). There were no significant differences in the median OS and RFS of the RUNX1mut and RUNX1wt groups (9.1 vs. 12.2 months; p = 0.268 and 7.8 vs. 14.6 months; p = 0.481, respectively). A subgroup analysis of de novo AML patients with intermediate-risk cytogenetics showed similar outcomes. Our meta-analysis pooled data from 23 studies and our study. The complete remission rate was significantly lower in the RUNX1mut group (pooled odds ratio: 0.42). The OS, RFS, and event-free survival rates also favored the RUNX1wt group (pooled risk ratios: 1.36, 1.37, and 1.37, respectively). A subgroup analysis of de novo AML patients with intermediate-risk cytogenetics demonstrated nearly identical OS and RFS outcomes. This study confirms that patients with AML and RUNX1mut had poor prognoses. Nonetheless, in de novo AML with intermediate-risk cytogenetics, the survival outcomes of both groups were comparable.

Clinical characteristics and prognosis of acute myeloid leukemia patients with Runt‐related transcription factor 1 mutation: A single‐center retrospective analysis

“…This finding was consistent with that in the report of Rungjirajittranon, T., et al 16 In addition, the 3-year OS and DFS of AML-RUNX1 mut in our study were 73.1% and 80.7%. The survival outcomes of AML-RUNX1 mut were comparable with those in AML-RUNX1 wt in our study, which were consistent with the results of prior studies.…”

“…In our study, the CRc rate of AML-RUNX1 mut was 88.9%, which was significantly higher than that (range, 15.8%-68.4%) in some previous studies. 2,6,16,22 The median age of AML-RUNX1 mut in our study was 46 years (range, 27-73 years). However, the median age of AML-RUNX1 mut in prior studies was 56.5-70.5 years.…”

“…16,17,24 Nevertheless, some studies have shown that AML-RUNX1 mut were associated with shorter survival, in which the median OS of AML-RUNX1 mut were 9.1-12.6 months. 2,6,16,23 Overall, the survival outcomes of AML-RUNX1 mut in our study were better than previously reported. Several reasons may contribute to this.…”

“…The survival outcomes of AML-RUNX1 mut were comparable with those in AML-RUNX1 wt in our study, which were consistent with the results of prior studies. 16,17,24 Nevertheless, some studies have shown that AML-RUNX1 mut were associated with shorter survival, in which the median OS of AML-RUNX1 mut were 9.1-12.6 months. 2,6,16,23 Overall, the survival outcomes of AML-RUNX1 mut in our study were better than previously reported.…”

“…15 However, several studies have showed different survival outcomes. 16,17 Thus, the clinical characteristic and prognosis of AML-RUNX1 mut is heterogeneous and need further research. We performed a retrospective analysis to investigate the differences in clinical characteristics and prognosis between AML-RUNX1 mut and AML-RUNX1 wt , and to analyze some factors that might affect the prognosis of AML-RUNX1 mut .…”