Clinical Outcomes of Acute Myeloid Leukemia Patients Harboring the RUNX1 Mutation: Is It Still an Unfavorable Prognosis? A Cohort Study and Meta-Analysis.

Content Provider	Europe PMC
Author	Rungjirajittranon, Tarinee Siriwannangkul, Theerapat Kungwankiattichai, Smith Leelakanok, Nattawut Rotchanapanya, Wannaphorn Vittayawacharin, Pongthep Mekrakseree, Benjamaporn Kulchutisin, Kamolchanok Owattanapanich, Weerapat
Editor	Thomas, Xavier
Copyright Year	2022
Abstract	Simple SummaryAcute myeloid leukemia (AML) with mutated RUNX1 (RUNX1mut) has an adverse prognosis based on the 2022 European LeukemiaNet risk stratification. However, the WHO classifications of 2022 removed RUNX1 mutations from the unique entity because of various prognoses and treatment outcomes. Intriguingly, the overall survival (OS) and relapse-free survival (RFS) outcomes were similar in patients who had de novo AML with intermediate-risk cytogenetics with and without RUNX1mut. Our study endorsed an unfavorable prognosis of this entity.AbstractAcute myeloid leukemia (AML) with mutated RUNX1 (RUNX1mut) is considered to have an unfavorable prognosis. However, recent studies have reported comparable survival outcomes with wild-type RUNX1 (RUNX1wt). To assess the clinical outcomes of AML with and without RUNX1mut, we performed a prospective cohort study and systematic review and meta-analysis. The study enrolled 135 patients (27 with RUNX1mut; 108 with RUNX1wt). There were no significant differences in the median OS and RFS of the RUNX1mut and RUNX1wt groups (9.1 vs. 12.2 months; p = 0.268 and 7.8 vs. 14.6 months; p = 0.481, respectively). A subgroup analysis of de novo AML patients with intermediate-risk cytogenetics showed similar outcomes. Our meta-analysis pooled data from 23 studies and our study. The complete remission rate was significantly lower in the RUNX1mut group (pooled odds ratio: 0.42). The OS, RFS, and event-free survival rates also favored the RUNX1wt group (pooled risk ratios: 1.36, 1.37, and 1.37, respectively). A subgroup analysis of de novo AML patients with intermediate-risk cytogenetics demonstrated nearly identical OS and RFS outcomes. This study confirms that patients with AML and RUNX1mut had poor prognoses. Nonetheless, in de novo AML with intermediate-risk cytogenetics, the survival outcomes of both groups were comparable.
Journal	Cancers
Volume Number	14
PubMed Central reference number	PMC9659296
Issue Number	21
PubMed reference number	36358658
e-ISSN	20726694
DOI	10.3390/cancers14215239
Language	English
Publisher	MDPI
Publisher Date	2022-10-26
Access Restriction	Open
Rights License	Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). © 2022 by the authors.
Subject Keyword	acute myeloid leukemia genetic molecular mutation next-generation sequencing RUNX1
Content Type	Text
Resource Type	Article
Subject	Oncology Cancer Research