Distinct clinical and biological features of de novo acute myeloid leukemia with additional sex comb-like 1 (ASXL1) mutations
2010; Elsevier BV; Volume: 116; Issue: 20 Linguagem: Inglês
10.1182/blood-2010-05-283291
ISSN1528-0020
AutoresWen‐Chien Chou, Huai‐Hsuan Huang, Hsin‐An Hou, Chien‐Yuan Chen, Jih‐Luh Tang, Ming Yao, Woei Tsay, Bor‐Sheng Ko, Shang‐Ju Wu, Shang‐Yi Huang, Szu-Chun Hsu, Yao‐Chang Chen, Yen-Ning Huang, Yi-Chang Chang, Fen‐Yu Lee, Min-Chih Liu, Chia‐Wen Liu, Mei‐Hsuan Tseng, Chi‐Fei Huang, Hwei‐Fang Tien,
Tópico(s)Myeloproliferative Neoplasms: Diagnosis and Treatment
ResumoAbstract Mutations in the additional sex comb-like 1 (ASXL1) gene were recently shown in various myeloid malignancies, but they have not been comprehensively investigated in acute myeloid leukemia (AML). In this study, we analyzed ASXL1 mutations in exon 12 in 501 adults with de novo AML. ASXL1 mutations were detected in 54 patients (10.8%), 8.9% among those with normal karyotype and 12.9% among those with abnormal cytogenetics. The mutation was closely associated with older age, male sex, isolated trisomy 8, RUNX1 mutation, and expression of human leukocyte antigen–DR and CD34, but inversely associated with t(15;17), complex cytogenetics, FLT3–internal tandem duplication, NPM1 mutations, WT1 mutations, and expression of CD33 and CD15. Patients with ASXL1 mutations had a shorter overall survival than patients without, but the mutation was not an independent adverse prognostic factor in multivariate analysis. Sequential analyses showed that the original ASXL1 mutations were lost at relapse and/or refractory status in 2 of the 6 relapsed ASXL1-mutated patients studied, whereas 2 of the 109 ASXL1-wild patients acquired a novel ASXL1 mutation at relapse. In conclusion, AML bearing ASXL1 mutations showed distinct clinical and biological features. The ASXL1 mutation status can change during disease evolution in a few patients.
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