Genetic alterations affecting clinical outcome of cytogenetically normal acute myeloid leukemia (AML) patients.
| Genetic Alteration . | Prognostic Significance . |
|---|---|
| Abbreviations: NPM1, nucleophosmin (nucleolar phosphoprotein B23, numatrin); FLT3-ITD, internal tandem duplication of the fms-related tyrosine kinase 3 (FLT3) gene; CR, complete remission; EFS, event-free survival, RFS, relapse-free survival; DFS, disease-free survival; OS, overall survival; CEBPA, CCAAT/enhancer binding protein (C/EBP), alpha; CRD, CR duration; MLL-PTD, partial tandem duplication of the myeloid/lymphoid or mixed-lineage leukemia (MLL) gene; BAALC, brain and acute leukemia gene, cytoplasmic; ERG, v-ets erythroblastosis virus E26 oncogene like (avian); CIR, cumulative incidence of relapse. | |
| Favorable | |
| NPM1 mutations | Patients with NPM1 mutations who do not harbor FLT3-ITD have significantly better CR rates, EFS, RFS, DFS, and OS than patients without NPM1 mutations and FLT3-ITD. NPM1 mutations do not have a significant effect on prognosis of patients with FLT3-ITD. |
| CEBPA mutations | Patients with CEBPA mutations have CRD and OS significantly longer than patients with the wild-type CEBPA gene. |
| Unfavorable | |
| FLT3 -ITD | Patients with FLT3-ITD have significantly shorter CRD, DFS and OS than patients who do not harbor FLT3-ITD. Particularly poor prognosis is conferred by FLT3-ITD coupled with no expression of a FLT3 wild-type allele or a high FLT3 mutant to FLT3 wild-type allele ratio. |
| MLL-PTD | Patients with MLL-PTD have remission duration significantly shorter than patients without MLL-PTD. |
| BAALC overexpression | Patients with high expression of the BAALC gene in blood have significantly worse CR rates and shorter DFS, EFS and OS than patients with low expression of the BAALC gene. |
| ERG overexpression | Patients with high expression of the ERG gene in blood have significantly shorter OS and higher CIR than patients with low expression of the ERG gene. |
| Genetic Alteration . | Prognostic Significance . |
|---|---|
| Abbreviations: NPM1, nucleophosmin (nucleolar phosphoprotein B23, numatrin); FLT3-ITD, internal tandem duplication of the fms-related tyrosine kinase 3 (FLT3) gene; CR, complete remission; EFS, event-free survival, RFS, relapse-free survival; DFS, disease-free survival; OS, overall survival; CEBPA, CCAAT/enhancer binding protein (C/EBP), alpha; CRD, CR duration; MLL-PTD, partial tandem duplication of the myeloid/lymphoid or mixed-lineage leukemia (MLL) gene; BAALC, brain and acute leukemia gene, cytoplasmic; ERG, v-ets erythroblastosis virus E26 oncogene like (avian); CIR, cumulative incidence of relapse. | |
| Favorable | |
| NPM1 mutations | Patients with NPM1 mutations who do not harbor FLT3-ITD have significantly better CR rates, EFS, RFS, DFS, and OS than patients without NPM1 mutations and FLT3-ITD. NPM1 mutations do not have a significant effect on prognosis of patients with FLT3-ITD. |
| CEBPA mutations | Patients with CEBPA mutations have CRD and OS significantly longer than patients with the wild-type CEBPA gene. |
| Unfavorable | |
| FLT3 -ITD | Patients with FLT3-ITD have significantly shorter CRD, DFS and OS than patients who do not harbor FLT3-ITD. Particularly poor prognosis is conferred by FLT3-ITD coupled with no expression of a FLT3 wild-type allele or a high FLT3 mutant to FLT3 wild-type allele ratio. |
| MLL-PTD | Patients with MLL-PTD have remission duration significantly shorter than patients without MLL-PTD. |
| BAALC overexpression | Patients with high expression of the BAALC gene in blood have significantly worse CR rates and shorter DFS, EFS and OS than patients with low expression of the BAALC gene. |
| ERG overexpression | Patients with high expression of the ERG gene in blood have significantly shorter OS and higher CIR than patients with low expression of the ERG gene. |