Molecular abnormalities and clinical features in adult patients with acute myeloid leukemia in Thailand
4
Issued Date
2025-12-01
Resource Type
eISSN
17461596
Scopus ID
2-s2.0-105021522639
Journal Title
Diagnostic Pathology
Volume
20
Issue
1
Rights Holder(s)
SCOPUS
Bibliographic Citation
Diagnostic Pathology Vol.20 No.1 (2025)
Suggested Citation
Chantrathammachart P., Jinawath A., Puavilai T., Arsa L., Police P., Noikongdee P., Phojanasenee T., Sae-Lim P., Piyajaroenkij T., Choksomnuk P., Chuncharunee S., Niparuck P. Molecular abnormalities and clinical features in adult patients with acute myeloid leukemia in Thailand. Diagnostic Pathology Vol.20 No.1 (2025). doi:10.1186/s13000-025-01725-z Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/113147
Title
Molecular abnormalities and clinical features in adult patients with acute myeloid leukemia in Thailand
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Abstract
Background: The genetic heterogeneity observed in acute myeloid leukemia (AML) contributes to a wide range of clinical presentations and prognoses. We conducted a retrospective study to investigate genetic abnormalities, clinical characteristics, and survival of AML patients. Methods: Targeted exome analysis of 25 genes using a QIAact Myeloid DNA UMI Panel with the GeneReader NGS was performed. Results: De novo AML (dAML) and secondary AML (sAML) were observed in 163 and 56 patients, respectively. ASXL1, SRSF2, and RUNX1 mutations were significantly observed in sAML patients. Among dAML patients, mutant IDH1, ASXL1, TP53, and TET2 were associated with low WBC count (< 4 × 10<sup>9</sup>/L), and mutations of FLT3-ITD and NPM1 were associated with high WBC count (> 100 × 10<sup>9</sup>/L). In dAML group, KIT and FLT3-TKD mutations were commonly found in favorable cytogenetic risk, RAS and SF3B1 mutations were significantly observed in the abnormal chromosome 3 group, whereas IDH1, IDH2, RUNX1, and SRSF2 mutations were significantly observed in trisomy group. Mutant TP53 was seen significantly in AML patients with complex and monosomy karyotypes. ASXL1, IDH1, IDH2, TP53, and SRSF2 mutations were independent factors associated with poor OS through univariate analysis. Nevertheless, multivariate analysis showed IDH1 (HR = 2.699; 95% CI: 1.331–5.473), TP53 (HR = 2.200; 95% CI: 1.409–3.435) and ASXL1 (HR = 1.592; 95% CI: 1.040–2.436) mutations were significantly associated with short OS in AML patients. In contrast, RUNX1 (HR = 3.667; 95% CI: 1.213–11.084) and DNMT3A (HR = 2.094; 95% CI: 1.080–4.081) mutations were significantly associated with poor DFS on multivariate analysis. Conclusions: The complexity of AML was influenced by various cytogenetic and molecular abnormalities, which contributed to patients’ heterogeneous presentation and survival outcomes. In addition to the previous data, IDH1, IDH2, and DNMT3A mutations might have affected survival outcomes in AML patients in our retrospective cohort. However, further studies with larger sample sizes are needed to validate these observations.