Predictive and Prognostic Markers in Adults With Acute Myeloid Leukemia: A Single-Institution Experience

Gbadamosi, Bolanle; Ezekwudo, Daniel; Bastola, Sanjog; Jaiyesimi, Ishmael

doi:10.1016/j.clml.2018.05.005

Cited by 11 publications

(13 citation statements)

References 38 publications

(48 reference statements)

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“…The current result agrees with other data. 5,8,9 Among the 4 positive AML patients for RUNX1/RUNX1T1 fusion gene expression, M2 FAB subtype was revealed in all the cases (100%). The result in the current study is in agreement with that of other studies.…”

Section: Discussionmentioning

confidence: 99%

Detection of RUNX1-RUNX1T1 Fusion Gene in AML Patients by FISH Technique in Iraq

AL-Saidi

2021

JCD

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Background: AML with t(8;21)(q22;q22.1) is a balanced translocation that results in the fusion of RUNX1 and RUNX1T1. The translocation product is located on derivative chromosome 8. It has characteristic morphologic and immunophenotypic features and is linked with good prognosis. t(8;21)(q22;q22.1) AML is diagnostic of AML regardless of blast count. Objectives: To detect the RUNX1-RUNX1T1 fusion gene) in patients with AML by FISH technique and to investigate the relation between this chromosomal abnormality and the immunophenotypic markers CD117, cMPO, CD34, CD13, CD64 and CD33, clinical features and haematological parameters (Hb, WBC, blast percentage and platelets). Materials ad Methods: Fifty patients with de novo AML were selected sequentially from Baghdad teaching hospital in medical city from June 2020 till April 2021. History was taken and data were collected for each patient using a questionnaire form that included: name, age, sex, symptoms and physical signs. The data of haematological parameters and CD markers expression were collected from the patients’ diagnostic reports. Results:The RUNX1/RUNX1T1 fusion gene expression was positive in 4 patients representing 8% whereas 46 patients representing 92% of the samples had negative gene expression. Among the 4 positive AML patients for RUNX1/RUNX1T1 fusion gene expression, M2FAB subtype was revealed in all the cases. All the positive cases expressed CD117 and CD34 markers, while it was noted that 3 out of 4 positive cases were having cMPO and CD13 markers and one positive case expressed CD33 and CD64. Conclusion: It’s shown that RUNX1-RUNX1T1 fusion gene frequency in AML Iraqi patients is similar to international reports.

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Section: Discussionmentioning

confidence: 99%

Detection of RUNX1-RUNX1T1 Fusion Gene in AML Patients by FISH Technique in Iraq

AL-Saidi

2021

JCD

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“…High-quality evidence showed that the risk of death was 1.17 times higher when patients 5 years younger were compared with patients 5 years older than the median age (hazard ratio [HR] [95% confidence interval per 5-year increase in age], 1.17 [1.11-1.23]). 29,56,[60][61][62][63][64][65][66][67][68][69][70][71][72] High-quality evidence showed that the risk of death was 1.72 times higher when patients with worse performance status (ECOG score of 21) were compared with those with better performance status (ECOG score of ,2) (HR [95% confidence interval], 1.72 [1.47-2.01]). 60,64,[73][74][75][76][77][78][79][80][81][82][83]123 There was also high-quality evidence showing that the risk of death was 1.59 times higher when patients with more comorbidities (HCT-CI score of 31) were compared with those with fewer comorbidities (HCT-CI score of ,3) (HR [95% confidence interval], 1.59 [1.28-1.98]).…”

Section: Prognosis In Older Adults With Amlmentioning

confidence: 99%

American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults

et al. 2020

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Background: Older adults with acute myeloid leukemia (AML) represent a vulnerable population in whom disease-based and clinical risk factors, patient goals, prognosis, and practitioner- and patient-perceived treatment risks and benefits influence treatment recommendations. Objective: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in their decisions about management of AML in older adults. Methods: ASH formed a multidisciplinary guideline panel that included specialists in myeloid leukemia, geriatric oncology, patient-reported outcomes and decision-making, frailty, epidemiology, and methodology, as well as patients. The McMaster Grading of Recommendations Assessment, Development and Evaluation (GRADE) Centre supported the guideline-development process, including performing systematic evidence reviews (up to 24 May 2019). The panel prioritized clinical questions and outcomes according to their importance to patients, as judged by the panel. The panel used the GRADE approach, including GRADE’s Evidence-to-Decision frameworks, to assess evidence and make recommendations, which were subject to public comment. Results: The panel agreed on 6 critical questions in managing older adults with AML, mirroring real-time practitioner-patient conversations: the decision to pursue antileukemic treatment vs best supportive management, the intensity of therapy, the role and duration of postremission therapy, combination vs monotherapy for induction and beyond, duration of less-intensive therapy, and the role of transfusion support for patients no longer receiving antileukemic therapy. Conclusions: Treatment is recommended over best supportive management. More-intensive therapy is recommended over less-intensive therapy when deemed tolerable. However, these recommendations are guided by the principle that throughout a patient’s disease course, optimal care involves ongoing discussions between clinicians and patients, continuously addressing goals of care and the relative risk-benefit balance of treatment.

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“…Similarly, in another study, age <60 years, favourable cytogenetics, de novo AML and leukocyte count at the time of diagnosis of <4 x 109/L were shown to be associated with higher PFS and OS (20). In another retrospective study of 137 adult AML patients between 2010 and 2015, predictive factors for OS and CR were shown to be age and the presence of monosomy (21). Analysis of survival data in two different studies revealed that age is a highly significant prognostic factor even in cytogenetic risk subgroups (22,23).…”

Section: Discussionmentioning

confidence: 77%

Are the conventional risk factors still valid for acute myeloid leukemia patients?

Yıldız

Maral

Albayrak

et al. 2020

Konuralp Tıp Dergisi

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The aim of this study was to investigate the survival data of patients with acute myeloid leukemia (AML) and to determine the risk factors that can be easily evaluated. Methods: A retrospective analysis was made of the AML patients admitted to our center between 2009 and 2018. Demographic and disease data were analyzed and response rates, overall survival (OS) and progression-free survival (PFS) rates were calculated. Factors affecting survival were determined using Cox-regression analysis. Results: A total of 119 patients were included in the study during the 9-year study period. Of these, 21 patients had secondary AML and 11 had acute promyelocytic leukemia (AML-M3). The mean follow-up period was 12.43 ± 15.63 months. OS of all patients was 9.20 months and PFS was 7.23 months. Age and leukocyte count at the time of diagnosis were significantly found to have adverse effect on both OS and PFS (p <0.05). Conclusions: In addition to genetic and molecular features, which are expensive and difficult to obtain, the age and leukocyte count of AML patients remain important as conventional prognostic factors.

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Predictive and Prognostic Markers in Adults With Acute Myeloid Leukemia: A Single-Institution Experience

Abstract: Positive predictors of CR in adult AML include absence of monosomy and induction treatment with 3+7; whereas positive predictors of OS are younger age and absence of monosomy.

Cited by 11 publications

References 38 publications

Detection of RUNX1-RUNX1T1 Fusion Gene in AML Patients by FISH Technique in Iraq

Detection of RUNX1-RUNX1T1 Fusion Gene in AML Patients by FISH Technique in Iraq

American Society of Hematology 2020 guidelines for treating newly diagnosed acute myeloid leukemia in older adults

Are the conventional risk factors still valid for acute myeloid leukemia patients?

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