Therapeutic effect of allogeneic stem cell transplantation in acute myeloid leukemia patients with epigenetic modifier gene mutations

Abstract

Abstract Background Epigenetic modifier gene mutations (EMM) have been reported to be associated with poor prognosis in acute myeloid leukemia (AML). Whether allogeneic stem cell transplantation (allo-HSCT) can improve outcomes in this patients remains unknown.Material/Methods: This study retrospectively collected clinical information of 353 AML patients with gene mutations detected by next-generation sequencing (NGS) and analyzed the therapeutic effect of allogeneic stem cell transplantation in acute myeloid leukemia patients with epigenetic modifier gene mutations.Results EMM-positive patients tended to have inferior OS compared with EMM-negative patients (p = 0.065, HR = 1.343, 95%CI: 0.981–1.838), EMM-positive patients had inferior LFS (p = 0.031, HR = 1.385, 95%CI: 1.030–1.863). In EMM-positive patients, multivariate analysis showed that patients who received allo-HSCT had a superior OS (yes vs. no, p < 0.001, HR = 0.213, 95%CI: 0.134–0.339, Table 3) and LFS (yes vs. no, p < 0.001, HR = 0.303, 95%CI: 0.199–0.461, Table 3) compared with patients who did not receive allo-HSCT. A total of 220 patients received allo-HSCT in all patients. Univariate analysis in patients undergoing allo-HSCT showed that EMM was not a risk factor for OS (EMM-positive vs. EMM-negative, p = 0.470, HR = 1.192, 95%CI: 0.740–1.920) and LFS (EMM-positive vs. EMM-negative, p = 0.323, HR = 1.235, 95%CI: 0.813–1.876).Conclusion EMM tended to be a poor risk factor for OS and was a poor risk factor for LFS in our cohort. Allo-HSCT might improve the OS and LFS of EMM-positive patients.