Poor Survival and Differential Impact of Genetic Features of Black Patients with Acute Myeloid Leukemia.
Poor Survival and Differential Impact of Genetic Features of Black Patients with Acute Myeloid Leukemia.
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DOI：
10.1158/2159-8290.cd-20-1579
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发表时间：
2021-03
期刊：
影响因子：
28.2
通讯作者：
Eisfeld AK
中科院分区：
文献类型：
--
作者：
Bhatnagar B;Kohlschmidt J;Mrózek K;Zhao Q;Fisher JL;Nicolet D;Walker CJ;Mims AS;Oakes C;Giacopelli B;Orwick S;Boateng I;Blachly JS;Maharry SE;Carroll AJ;Powell BL;Kolitz JE;Stone RM;Byrd JC;Paskett ED;de la Chapelle A;Garzon R;Eisfeld AK
急性髓系白血病 (AML) 患者的临床结果与细胞遗传学和分子因素以及患者人口统计数据（例如年龄和种族）相关。我们使用流行病学监测和最终结果 (SEER) 计划数据比较了 25,523 名患有 AML 的非西班牙裔黑人和白人成人的生存情况，并对接受一线肿瘤临床试验联盟 (Alliance) 方案治疗的 1,339 名 AML 患者进行了突变分析。在 SEER 和联盟临床试验中，黑人患者的生存期比白人患者短。在调整社会经济 (SEER) 和分子 (联盟) 因素后，这种差异在 60 岁以下的黑人患者中尤其明显。黑人种族是生存不佳的独立预测者。基因突变谱显示，年轻黑人患者中 NPM1 突变较少，IDH2 突变较多。年轻黑人患者的总体生存率受到 IDH2 突变和 FLT3-ITD 的不利影响，但与白人患者相比，NPM1 突变并未改善其总体生存率。
Clinical outcome of patients with acute myeloid leukemia (AML) is associated with cytogenetic and molecular factors and patient demographics (e.g., age and race). We compared survival of 25,523 Non-Hispanic Black and White adults with AML using Surveillance Epidemiology and End Results (SEER) Program data, and performed mutational profiling of 1,339 AML patients treated on frontline Alliance for Clinical Trials in Oncology (Alliance) protocols. Black patients had shorter survival than White patients, both in SEER and in the setting of Alliance clinical trials. The disparity was especially pronounced in Black patients <60 years, after adjustment for socioeconomic (SEER) and molecular (Alliance) factors. Black race was an independent prognosticator of poor survival. Gene mutation profiles showed fewer NPM1 and more IDH2 mutations in younger Black patients. Overall survival of younger Black patients was adversely affected by IDH2 mutations and FLT3-ITD, but, in contrast to White patients, was not improved by NPM1 mutations.