Blast Clearance Dynamics and Time to Response Across and -Mutated AML.
[BACKGROUND] mutations are found in 15%-20% of acute myeloid leukemia (AML).
APA
Najeeb MS, Alkabbani O, et al. (2025). Blast Clearance Dynamics and Time to Response Across and -Mutated AML.. EJHaem, 6(6), e70204. https://doi.org/10.1002/jha2.70204
MLA
Najeeb MS, et al.. "Blast Clearance Dynamics and Time to Response Across and -Mutated AML.." EJHaem, vol. 6, no. 6, 2025, pp. e70204.
PMID
41404482
Abstract
[BACKGROUND] mutations are found in 15%-20% of acute myeloid leukemia (AML). Recent evidence suggests that mutation subtypes may respond differently to intensive chemotherapy. We evaluated blast clearance patterns, remission outcomes, and overall survival (OS) in AML patients with R140, R172, and R132 mutations to assess differences in treatment response.
[METHODS] We retrospectively reviewed AML patients diagnosed at Mayo Clinic, Rochester (2016-2023) with NGS data and treated with intensive chemotherapy (7+3 or CPX-351). Bone marrow blasts were assessed at diagnosis, mid-induction, and end-of-cycle; blast clearance was defined as < 5%. Composite remission (CRc) included CR/CRi per ELN 2022. responders were classified as early (after Cycle 1) or late (≥ 2 cycles). Blast reduction was calculated as log (diagnosis blasts/end-induction blasts) and normalized per day. OS was measured from diagnosis.
[RESULTS] Among 381 patients, 31 had mutations (23 R140, 8 R172) and eight had R132. Baseline blasts were similar. Mid-cycle blasts were lower in R140 versus R172 (4% vs. 10%), with higher clearance (68% vs. 38%). End-induction blasts were lower in R140 versus R172 (2% vs. 4%) with higher clearance (100% vs. 75%). and showed similar clearance patterns. Log analyses showed deeper and faster blast reduction in R140 versus R172, with comparable kinetics between and . OS did not differ across subtypes. Early CRc in -mutated patients was associated with numerically longer OS.
[CONCLUSION] R140 demonstrated faster blast clearance than R172, while remission and survival were similar across subtypes. : The authors have confirmed clinical trial registration is not needed for this submission.
[METHODS] We retrospectively reviewed AML patients diagnosed at Mayo Clinic, Rochester (2016-2023) with NGS data and treated with intensive chemotherapy (7+3 or CPX-351). Bone marrow blasts were assessed at diagnosis, mid-induction, and end-of-cycle; blast clearance was defined as < 5%. Composite remission (CRc) included CR/CRi per ELN 2022. responders were classified as early (after Cycle 1) or late (≥ 2 cycles). Blast reduction was calculated as log (diagnosis blasts/end-induction blasts) and normalized per day. OS was measured from diagnosis.
[RESULTS] Among 381 patients, 31 had mutations (23 R140, 8 R172) and eight had R132. Baseline blasts were similar. Mid-cycle blasts were lower in R140 versus R172 (4% vs. 10%), with higher clearance (68% vs. 38%). End-induction blasts were lower in R140 versus R172 (2% vs. 4%) with higher clearance (100% vs. 75%). and showed similar clearance patterns. Log analyses showed deeper and faster blast reduction in R140 versus R172, with comparable kinetics between and . OS did not differ across subtypes. Early CRc in -mutated patients was associated with numerically longer OS.
[CONCLUSION] R140 demonstrated faster blast clearance than R172, while remission and survival were similar across subtypes. : The authors have confirmed clinical trial registration is not needed for this submission.