Synergistic adverse prognosis of and co-mutation in acute myeloid leukemia: a retrospective cohort study.
코호트
1/5 보강
[BACKGROUND] Current prognostic stratification for acute myeloid leukemia (AML) patients primarily relies on international guidelines such as ELN 2022.
- 95% CI 1.244-6.333
- OR 2.807
- HR 1.11
- 연구 설계 cohort study
APA
Qu F, Hui M, et al. (2026). Synergistic adverse prognosis of and co-mutation in acute myeloid leukemia: a retrospective cohort study.. Frontiers in cell and developmental biology, 14, 1775927. https://doi.org/10.3389/fcell.2026.1775927
MLA
Qu F, et al.. "Synergistic adverse prognosis of and co-mutation in acute myeloid leukemia: a retrospective cohort study.." Frontiers in cell and developmental biology, vol. 14, 2026, pp. 1775927.
PMID
41929630
Abstract
[BACKGROUND] Current prognostic stratification for acute myeloid leukemia (AML) patients primarily relies on international guidelines such as ELN 2022. However, these guidelines provide limited explicit guidance on how to comprehensively assess prognosis when patients harbor concurrent multiple gene mutations, potentially leading to inaccurate risk stratification.
[METHODS] This retrospective cohort study enrolled 299 adult AML patients (median age: 53.5 years). Clinical features, mutation status of prognosis-related genes, complete remission (CR) rate after two induction courses, and overall survival (OS) were analyzed. Logistic regression and Cox proportional hazards models were employed.
[RESULTS] In this study cohort, the incidence rates of and CEBPA single mutations were 15.38% (46/299) and 13.37% (40/299), respectively, while the and co-mutation rate was 4.68% (14/299). Both univariate and multivariate logistic regression analyses demonstrated that mutation (OR = 2.807, 95% CI: 1.244-6.333, = 0.013) and mutation (OR = 4.028, 95% CI: 1.760-9.219, = 0.001) were independent positive predictive factors for achieving complete remission after two treatment courses. Survival analysis indicated that neither single mutation (HR = 1.11, 95% CI: 0.60-2.04, = 0.738) nor single mutation (HR = 0.70, 95% CI: 0.36-1.34, = 0.280) was significantly associated with overall survival. Notably, and co-mutation was confirmed as an independent adverse prognostic factor, conferring a 3.15-fold increased risk of death (HR = 3.15, 95% CI: 1.08-9.21, = 0.036) compared to patients without either mutation.
[CONCLUSION] The and co-mutation defines a distinct molecular subtype with independently poor prognosis in AML. Routine mutation screening in patients with -mutated AML is warranted to refine risk stratification, particularly for identifying this high-risk subgroup, which may benefit from more intensive or novel therapeutic approaches.
[METHODS] This retrospective cohort study enrolled 299 adult AML patients (median age: 53.5 years). Clinical features, mutation status of prognosis-related genes, complete remission (CR) rate after two induction courses, and overall survival (OS) were analyzed. Logistic regression and Cox proportional hazards models were employed.
[RESULTS] In this study cohort, the incidence rates of and CEBPA single mutations were 15.38% (46/299) and 13.37% (40/299), respectively, while the and co-mutation rate was 4.68% (14/299). Both univariate and multivariate logistic regression analyses demonstrated that mutation (OR = 2.807, 95% CI: 1.244-6.333, = 0.013) and mutation (OR = 4.028, 95% CI: 1.760-9.219, = 0.001) were independent positive predictive factors for achieving complete remission after two treatment courses. Survival analysis indicated that neither single mutation (HR = 1.11, 95% CI: 0.60-2.04, = 0.738) nor single mutation (HR = 0.70, 95% CI: 0.36-1.34, = 0.280) was significantly associated with overall survival. Notably, and co-mutation was confirmed as an independent adverse prognostic factor, conferring a 3.15-fold increased risk of death (HR = 3.15, 95% CI: 1.08-9.21, = 0.036) compared to patients without either mutation.
[CONCLUSION] The and co-mutation defines a distinct molecular subtype with independently poor prognosis in AML. Routine mutation screening in patients with -mutated AML is warranted to refine risk stratification, particularly for identifying this high-risk subgroup, which may benefit from more intensive or novel therapeutic approaches.
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