Influence of clinical-biologic characteristics and gene expression profile at diagnosis in 121 CN-AML patients regarding their OS and RFS
. | OS (n = 121) . | RFS (n = 100) . | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
n . | 2-year, % . | Univariate . | Multivariate* . | HR (95% CI)† . | n . | 2-year, % . | Univariate . | Multivariate* . | HR (95% CI)† . | |
Clinical-biologic feature | ||||||||||
WBC at diagnosis, × 109/L‡ | .001 | < .001 | .018 | .031 | ||||||
Less than or equal to 50.0 | 88 | 62 | 2.8 (1.6-4.8) | 76 | 64 | 2.1 (1.0-5.2) | ||||
More than 50.0 | 33 | 35 | 24 | 33 | ||||||
Age, y‡§ | .003 | .004 | .008 | .006 | ||||||
Less than or equal to 65 | 97 | 59 | 2.5 (1.3-4.5) | 84 | 62 | 2.7 (1.4-5.6) | ||||
More than 65 | 24 | 36 | 16 | 28 | ||||||
FLT3/NPM1 phenotype | .070 | .055 | .030 | .037 | ||||||
FLT3wt/NPM1mutated | 38 | 61 | ND | 34 | 70 | 2.1 (1.1-4.0) | ||||
Other phenotypes | 83 | 50 | 66 | 49 | ||||||
Sex | .080 | > .1 | .056 | .074 | ||||||
Male | 61 | 47 | ND | 49 | 48 | ND | ||||
Female | 60 | 60 | 51 | 63 | ||||||
Platelet at diagnosis, × 109/L‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 60 | 61 | 49 | ND | 51 | 50 | ND | ||||
More than 60 | 60 | 59 | 49 | 62 | ||||||
Hemoglobin, g/dL‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 9.1 | 61 | 56 | ND | 51 | 60 | ND | ||||
More than 9.1 | 60 | 52 | 49 | 51 | ||||||
PB blasts at diagnosis, %‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 44 | 61 | 55 | ND | 52 | 56 | ND | ||||
More than 44 | 60 | 53 | 48 | 54 | ||||||
BM blasts at diagnosis, %‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 67 | 61 | 53 | ND | 61 | 56 | ND | ||||
More than 67 | 60 | 54 | 60 | 55 | ||||||
Gene expression (quartiles)¶ | ||||||||||
ERG (median) | .020 | .024 | .010 | .014 | ||||||
Less than or equal to 0.54 | 61 | 66 | 1.9 (1.1-3.3) | 54 | 67 | 2.2 (1.1-3.8) | ||||
More than 0.54 | 60 | 42 | 46 | 44 | ||||||
PRAME (75th percentile) | .035 | .066 | .017 | .026 | ||||||
Less than or equal to 150 | 91 | 51 | ND | 74 | 48 | 0.4 (0.2-0.9) | ||||
More than 150 | 30 | 63 | 26 | 79 | ||||||
EVI-1 (75th percentile) | .030 | .050 | ||||||||
Less than or equal to 0.2 | 91 | 59 | .042 | 1.9 (1.0-3.3) | 77 | 60 | .051 | 2.0 (1.0-3.8) | ||
More than 0.2 | 30 | 42 | 23 | 46 | ||||||
MLL-PTD (75th percentile) | > .1 | .061 | > .1 | |||||||
Less than or equal to 0.3 | 91 | 56 | ND | ND | 73 | 59 | ND | |||
More than 0.3 | 30 | 46 | 27 | 46 | ||||||
WT1 (75th percentile) | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 374 | 91 | 56 | ND | 75 | 59 | ND | ||||
More than 374 | 30 | 46 | 25 | 47 | ||||||
MN1 (median) | > .1 | ND | ND | |||||||
Less than or equal to 50 | 61 | 59 | ND | 54 | 58 | > .1 | ND | |||
More than 50 | 60 | 47 | 46 | 53 | ||||||
RHAMM (75th percentile) | > .1 | ND | ND | |||||||
Less than or equal to 1.3 | 91 | 55 | ND | 75 | 57 | > .1 | ND | |||
More than 1.3 | 30 | 47 | 25 | 52 |
. | OS (n = 121) . | RFS (n = 100) . | ||||||||
---|---|---|---|---|---|---|---|---|---|---|
n . | 2-year, % . | Univariate . | Multivariate* . | HR (95% CI)† . | n . | 2-year, % . | Univariate . | Multivariate* . | HR (95% CI)† . | |
Clinical-biologic feature | ||||||||||
WBC at diagnosis, × 109/L‡ | .001 | < .001 | .018 | .031 | ||||||
Less than or equal to 50.0 | 88 | 62 | 2.8 (1.6-4.8) | 76 | 64 | 2.1 (1.0-5.2) | ||||
More than 50.0 | 33 | 35 | 24 | 33 | ||||||
Age, y‡§ | .003 | .004 | .008 | .006 | ||||||
Less than or equal to 65 | 97 | 59 | 2.5 (1.3-4.5) | 84 | 62 | 2.7 (1.4-5.6) | ||||
More than 65 | 24 | 36 | 16 | 28 | ||||||
FLT3/NPM1 phenotype | .070 | .055 | .030 | .037 | ||||||
FLT3wt/NPM1mutated | 38 | 61 | ND | 34 | 70 | 2.1 (1.1-4.0) | ||||
Other phenotypes | 83 | 50 | 66 | 49 | ||||||
Sex | .080 | > .1 | .056 | .074 | ||||||
Male | 61 | 47 | ND | 49 | 48 | ND | ||||
Female | 60 | 60 | 51 | 63 | ||||||
Platelet at diagnosis, × 109/L‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 60 | 61 | 49 | ND | 51 | 50 | ND | ||||
More than 60 | 60 | 59 | 49 | 62 | ||||||
Hemoglobin, g/dL‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 9.1 | 61 | 56 | ND | 51 | 60 | ND | ||||
More than 9.1 | 60 | 52 | 49 | 51 | ||||||
PB blasts at diagnosis, %‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 44 | 61 | 55 | ND | 52 | 56 | ND | ||||
More than 44 | 60 | 53 | 48 | 54 | ||||||
BM blasts at diagnosis, %‖ | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 67 | 61 | 53 | ND | 61 | 56 | ND | ||||
More than 67 | 60 | 54 | 60 | 55 | ||||||
Gene expression (quartiles)¶ | ||||||||||
ERG (median) | .020 | .024 | .010 | .014 | ||||||
Less than or equal to 0.54 | 61 | 66 | 1.9 (1.1-3.3) | 54 | 67 | 2.2 (1.1-3.8) | ||||
More than 0.54 | 60 | 42 | 46 | 44 | ||||||
PRAME (75th percentile) | .035 | .066 | .017 | .026 | ||||||
Less than or equal to 150 | 91 | 51 | ND | 74 | 48 | 0.4 (0.2-0.9) | ||||
More than 150 | 30 | 63 | 26 | 79 | ||||||
EVI-1 (75th percentile) | .030 | .050 | ||||||||
Less than or equal to 0.2 | 91 | 59 | .042 | 1.9 (1.0-3.3) | 77 | 60 | .051 | 2.0 (1.0-3.8) | ||
More than 0.2 | 30 | 42 | 23 | 46 | ||||||
MLL-PTD (75th percentile) | > .1 | .061 | > .1 | |||||||
Less than or equal to 0.3 | 91 | 56 | ND | ND | 73 | 59 | ND | |||
More than 0.3 | 30 | 46 | 27 | 46 | ||||||
WT1 (75th percentile) | > .1 | ND | > .1 | ND | ||||||
Less than or equal to 374 | 91 | 56 | ND | 75 | 59 | ND | ||||
More than 374 | 30 | 46 | 25 | 47 | ||||||
MN1 (median) | > .1 | ND | ND | |||||||
Less than or equal to 50 | 61 | 59 | ND | 54 | 58 | > .1 | ND | |||
More than 50 | 60 | 47 | 46 | 53 | ||||||
RHAMM (75th percentile) | > .1 | ND | ND | |||||||
Less than or equal to 1.3 | 91 | 55 | ND | 75 | 57 | > .1 | ND | |||
More than 1.3 | 30 | 47 | 25 | 52 |
HR indicates hazard ration; and ND, not done.
Multivariate analysis was performed by including those features with a P value < .1 in the univariate analysis. Only variables with a P value less than .05 in the Cox regression model were considered as having an independent prognostic value.
Hazard ratio (HR) was calculated for WBC > 50 × 109/L, age > 65 years, non-FLT3wt/NPM1mutated phenotype, and high ERG, EVI1, or PRAME expression.
Variables were dichotomized based on high-risk criteria.
Fifty-two of 84 (62%) patients younger than 65 years in complete remission underwent an autologous stem cell transplantation (SCT), whereas 19 (23%) received an allogeneic-SCT.
Variables were dichotomized based on median value.
For each gene, the quartile providing the best separation of survival curves (lowest P value) is shown.