Genetic Variations Predict Outcomes in Acute Leukemia
Findings can help guide treatment decisions for patients with cytogenetically normal AML
WEDNESDAY, April 30 (HealthDay News) -- While cytogenetic markers have known prognostic value in acute myeloid leukemia (AML), new research shows that among patients with cytogenetically normal AML who lack these traditional markers, genomic disruptions in leukemic cells can be used to predict outcomes and response to treatment, according to two studies published in the May 1 issue of the New England Journal of Medicine.
Guido Marcucci, M.D., of Ohio State University in Columbus, Ohio, and colleagues studied microRNA expression profiles in 64 patients with cytogenetically normal AML and high-risk molecular characteristics and derived a microRNA signature that was associated with event-free survival. The association persisted when the microRNA signature was tested in a validation group of 55 patients with cytogenetically normal AML.
In a second study, Richard F. Schlenk, M.D., of the University Hospital of Ulm in Ulm, Germany, and colleagues investigated the association of several gene mutations with clinical outcomes in 872 adults with cytogenetically normal AML, and found that various genotypes predicted the likelihood of complete remission and response to HLA-matched donor hematopoietic stem-cell transplantation.
The author of an associated editorial discusses how these findings can be used to inform the decision to proceed with stem-cell transplantation in individual patients: "An algorithm that integrates transplantation-related and disease-specific risk factors is likely to be the best predictor of outcome after allogeneic stem-cell transplantation in candidates for the procedure."