Clinical and molecular characteristics of acute myeloid leukemia and the dismal prognosis of mutations in a real-world setting.

Objectives: This study aimed to evaluate the incidence and prognostic significance of common cytogenetic and molecular abnormalities in patients with -mutated and non--mutated acute myeloid leukemia (AML).

Methods: We retrospectively analyzed the clinical data of 326 patients with newly diagnosed AML hospitalized in our institution between October 2015 and June 2021. Classification variables were reported as percentages and compared by χ tests. Survival rates were evaluated by the Kaplan-Meier method.

Results: The incidence of mutations in AML patients in this clinic was 9.8%, of whom 87.5% patients were over 50 years old. The common concurrent mutations of were , , and . Patients with a variant allele frequency (VAF) ≤ 40% had better overall survival (OS) than patients with a VAF >40%. Compared with non--mutated patients, significantly more mutated patients were gene-fusion negative, +mar, - 7/del (7q), - 5/del (5q), - 17/17p-, - 12/12p-, incomplete (inc) karyotype, or complex karyotype (CK), and had or mutations, as well as a lower complete remission (CR) rate (31.3%) and higher recurrence rate (80.0%). The 2-year OS rates of mutated and non-mutated patients were 18.8% and 47.3%, respectively (< 0.001). Univariate analysis showed that non-mutated patients with family gene fusion, +mar or - 17/17p - karyotype, and mutations had a poor prognosis, while t(8; 21) karyotype was associated with a better prognosis. mutated patients with - 7/del (7q) or - 5/del (5q) karyotype had a poor prognosis.

Conclusions: The cytogenetic and molecular landscapes differed between mutated and non-mutated patients, and some abnormalities had different values between them.