IDH1 and IDH2 mutations confer an adverse effect in patients with acute myeloid leukemia lacking the NPM1 mutation. (3rd March 2014)

• Record Type: Journal Article
• Authors: Yamaguchi, Shunichiro; Iwanaga, Eisaku; Tokunaga, Kenji; Nanri, Tomoko; Shimomura, Taizo; Suzushima, Hitoshi; Mitsuya, Hiroaki; Asou, Norio
• Is Part Of: European journal of haematology. Volume 92:Number 6(2014:Jun.)
• Page Start: 471
• Page End: 477
• Publication Date: 2014-03-03
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.12271
• Languages: English
• ISSNs: 0902-4441

Abstract

<abstract abstract-type="main" id="ejh12271-abs-0001"> <title>Abstract</title> <p>We examined the incidence and prognostic effect of <italic>IDH1</italic> and <italic>IDH2</italic> mutations in 233 Japanese adults with acute myeloid leukemia (AML). <italic>IDH1</italic> R132 mutations were detected in 20 (8.6%) patients with AML. <italic>IDH2</italic> mutations were found in 19 (8.2%, 17 R140 and two R172) patients. <italic>IDH1</italic> and <italic>IDH2</italic> mutations were mutually exclusive and were associated with normal karyotype AML, cytogenetic intermediate‐risk group, and <italic>NPM1</italic> mutations. Five‐year overall survival (OS) rates were significantly lower (15.6%) in patients harboring the <italic>IDH</italic> mutations than in patients lacking the <italic>IDH</italic> mutation (32.0%) in the entire cohort of AML (<italic>P </italic>=<italic> </italic>0.005). Among patients aged 59 yr or younger with <italic>IDH</italic> mutations, 5‐yr OS in patients who underwent allogeneic stem cell transplantation (SCT) was significantly higher than that in those not receiving allogeneic SCT (50% vs. 10.6%, <italic>P </italic>=<italic> </italic>0.020). Of 51 patients with <italic>NPM1</italic> mutations, there was no significant difference in 5‐yr OS rates between patients with and those without the <italic>IDH</italic> mutations. In contrast, among 175 patients lacking the <italic>NPM1</italic> mutations, 5‐yr OS rate in patients with <italic>IDH</italic> mutations was significantly lower than that in those without <italic>IDH</italic> mutations (0% vs. 34.7%, <italic>P </italic>= <0.001). These data suggest that <italic>IDH</italic> mutations have an unfavorable effect in AML, especially AML with the <italic>NPM1</italic> wild type and younger AML patients with <italic>IDH</italic> mutations may benefit from allogeneic SCT.</p> </abstract>