11 December 2019

Genetic analysis can help predict the chances of success of stem cell transplant for older patients with acute myeloid leukaemia (AML), a major haematology conference has heard.

Doctors at the Dana-Farber Cancer Institute in Boston, USA, unveiled a new way to classify older patients, which they say could help decide treatment choices for patients.

They reported their findings at the annual meeting of the American Society of Hematology (ASH) in Orlando, Florida, USA.

The research team sequenced 112 genes in diagnostic samples from 300 patients over the age of 60. All the patients had gone on to have an allogeneic stem cell transplant. They then related the gene mutations present in these samples to long-term outcomes, including leukaemia-free survival and overall survival.

This showed that mutations in TP53, or JAK2, or the presence of a ­FLT3 internal tandem duplication (FLT3-ITD) without an NPM1 mutation indicated the greatest risk of death or relapse. Just 5% of these patients were alive and free of disease after three years.

Conversely, patients with mutations in DNMT3A or DDX41 or with an NPM1 mutation (without FLT3-ITD) were at the lowest risk. 70% of these were alive and free of disease after three years.

Research fellow Moses Murdock said: “We've shown that genetic features of AML in older patients can predict outcomes after transplantation.

“Our findings will be useful in taking patients who are in remission and offering them the best path to a cure.”

The researchers believe that patients at low risk could receive treatments which minimise toxicity, and the highest-risk patients may benefit from clinical trials of new treatments to reduce risk of relapse.


Source: ASH Session 732, Abstract 48