Defining Acute Myeloid Leukemia Ontogeny in Older Patients

Publication date: Available online 9 November 2019Source: Clinical Lymphoma Myeloma and LeukemiaAuthor(s): Megan Melody, Andrew Kuykendall, David Sallman, Najla Al Ali, Ling Zhang, Chetasi Talati, Eric Padron, Kendra Sweet, Martine Extermann, Alan List, Jeffrey Lancet, Rami KomrokjiAbstractAML in elderly patients (pts) is associated with poor outcomes and often arises from antecedent hematological disorders (AHD), classified as secondary AML (sAML). In order to validate the use of somatic mutations to determine AML ontogeny in the elderly population, we identified 178 elderly (>70yo) AML pts with NexGen Sequencing data. Pts were divided clinically into pAML or sAML based on prior history of AHD. Pts were then reclassified into 4 groups based on somatic mutations and cytogenetics as suggested by Lindsley et al: group 1 (pAML) with CBF rearrangements, 11q23/MLL, and NPM1 mutation (MT); group 2 (sAML) with SRSF2, SF3B1, U2AF1, ZRSR2, ASXL1, EZH2, BCOR, or STAG2 MT; group 3 with TP53 MT; and group 4 as not otherwise specified (NOS). Based on clinical criteria, 95 pts were classified as pAML and 82 pts as sAML. Based on the AML ontogeny proposed, 8 pts were classified as pAML, 72 pts sAML, 28 pts had TP53 MT, and 70 pts were classified as NOS. The median overall survival was 22.4,14, 2.8, and 11.2 months, respectively. Clinical versus molecular classification was discordant where 25% of pts (n=2) classified as pAML by molecular signature had a history of AHD while 44% of pts (n=32...
Source: Clinical Lymphoma Myeloma and Leukemia - Category: Cancer & Oncology Source Type: research