Prognostic impact of IL7R mutations on acute myeloid leukemia.

IF 3.4 3区医学 Q2 HEMATOLOGY Therapeutic Advances in Hematology Pub Date : 2024-09-26 eCollection Date: 2024-01-01 DOI:10.1177/20406207241279533

Qiqi Tao, Qiaoyuan Wu, Yutong Xue, Changkun Chen, Ya Zhou, Ruoyang Shao, Haiyan Zhang, Hui Liu, Xiangzong Zeng, Lingling Zhou, Qifa Liu, Hua Jin

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Abstract

Background: Interleukin-7 receptor (IL7R) mutation has been demonstrated to be an adverse prognostic factor in acute lymphoblastic leukemia (ALL) patients. However, the effects of the IL7R mutation on acute myeloid leukemia (AML) have rarely been reported. Here, we investigated IL7R mutations and their effects on AML patients.

Methods: A total of 346 newly diagnosed AML patients from January 2017 to July 2020 at Nanfang Hospital were analyzed in this study. A genomic panel of 167 gene targets was detected by next-generation sequencing.

Results: Among 346 patients, 33 (9.5%) AML patients carried IL7R mutations. With a median follow-up of 50.7 months (95% confidence interval (CI) 17.3-62.2), the 5-year overall survival (OS) rates were 51.5% (95% CI 37.0%-71.0%) and 72.2% (95% CI 67.4%-77.3%; p = 0.008), the 5-year event-free survival (EFS) rates were 36.1% (95% CI 23.2%-57.1%) and 58.1% (95% CI 52.9%-63.8%; p = 0.005), the 5-year non-relapse mortality (NRM) were 21.4% (95% CI 8.5%-38.2%) and 6.2% (95% CI 3.7%-9.5%; p = 0.004) in the IL7R mutant (IL7R ^MUT ) group and non-IL7R mutant (IL7R ^WT ) group, respectively. There is no significant difference in the disease-free survival (75.1% vs 73.5%, p = 0.885) and cumulative incidence of relapse (25.7% vs 25.2%, p = 0.933) between IL7R ^MUT and IL7R ^WT group. Furthermore, patients who underwent hematopoietic stem cell transplantation (HSCT) still had more adverse outcomes in the IL7R ^MUT group than in the IL7R ^WT group (5-year OS: 61.9% vs 85.3%, p = 0.003). In the TET2 (p = 0.013) and DNA methyltransferase 3A (DNMT3A; p = 0.046) mutation subgroups, the presence of IL7R mutations was associated with worse OS than in AML patients without IL7R mutations.

Conclusion: Our study demonstrated that the IL7R mutation is associated with an inferior prognosis for AML patients. Patients with IL7R mutations have higher NRM, shorter OS, and EFS than patients without IL7R mutations, even patients who have undergone HSCT. Future larger and multicentric prospective studies will be explored.

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IL7R突变对急性髓性白血病的预后影响

背景：白细胞介素-7受体（IL7R）突变已被证实是急性淋巴细胞白血病（ALL）患者的不良预后因素。然而，IL7R突变对急性髓性白血病（AML）的影响却鲜有报道。在此，我们研究了IL7R突变及其对AML患者的影响：本研究共分析了南方医院2017年1月至2020年7月新诊断的346例AML患者。通过新一代测序检测了167个基因靶点的基因组面板：在346例患者中，33例（9.5%）AML患者携带IL7R突变。中位随访时间为50.7个月（95%置信区间（CI）17.3-62.2），5年总生存（OS）率分别为51.5%（95% CI 37.0%-71.0%）和72.2%（95% CI 67.4%-77.3%；P = 0.008），5年无事件生存（EFS）率分别为36.1%（95% CI 23.IL7R 突变（IL7R MUT ）组和非 IL7R 突变（IL7R WT ）组的 5 年无复发死亡率（NRM）分别为 21.4% (95% CI 8.5%-38.2%) 和 6.2% (95% CI 3.7%-9.5%; p = 0.004)。IL7R MUT 组和 IL7R WT 组的无病生存率（75.1% vs 73.5%，p = 0.885）和累积复发率（25.7% vs 25.2%，p = 0.933）无明显差异。此外，与IL7R WT组相比，接受造血干细胞移植（HSCT）的IL7R MUT组患者仍有更多不良结局（5年OS：61.9% vs 85.3%，p = 0.003）。在TET2（p = 0.013）和DNA甲基转移酶3A（DNMT3A；p = 0.046）突变亚组中，与无IL7R突变的AML患者相比，IL7R突变与较差的OS相关：我们的研究表明，IL7R突变与急性髓细胞白血病患者的不良预后有关。结论：我们的研究表明，IL7R突变与急性髓细胞性白血病患者的不良预后有关，与无IL7R突变的患者相比，IL7R突变患者的NRM更高，OS和EFS更短，即使是接受过造血干细胞移植的患者也是如此。未来将开展更大规模的多中心前瞻性研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Hematology HEMATOLOGY-

CiteScore

4.30

自引率

0.00%

发文量

审稿时长

7 weeks

期刊介绍： Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.