Clinical characteristics and prognosis of therapy-related acute myeloid leukemia patients with RUNX1::RUNX1T1.

BACKGROUND: This study aimed to analyze the clinical characteristics and prognostic factors in therapy-related acute myeloid leukemia (t-AML) patients with RUNX1::RUNX1T1 fusion. METHODS: A retrospective analysis was performed. Twenty-three t-AML patients with RUNX1::RUNX1T1 were included as the case group. Ninety-two de novo AML patients with RUNX1::RUNX1T1 were randomly selected using the case-pair method in a 1:4 ratio who matched for (1) sex, (2) age (± 5 years), (3) time of diagnosis (± 3 years). A total of 115 AML patients with RUNX1::RUNX1T1 were enrolled. RESULTS: The CR rate after two cycles in t-AML patients with RUNX1::RUNX1T1 was same to that in de novo AML patients with RUNX1::RUNX1T1(95.6% vs. 95.6%, p = 0.48). Survival analysis indicated the 3-year overall survival (OS) of t-AML and de novo AML patients with RUNX1::RUNX1T1 were 68.2% vs. 83.1% (P = 0.23), and 3-year disease-free survival (DFS) were 60.9% vs. 65.3% (P = 0.84). Multivariate analysis demonstrated that age ≥ 60 years, CCND3, DNMT3A and FLT3 mutation were independent adverse factors, but achieving MMR after three cycles were independent favorable factors for survival of AML patients with RUNX1::RUNX1T1. CONCLUSIONS: This study showed no significant differences in remission rates and survival between the two groups. Multivariate analysis demonstrated that age ≥ 60 years, CCND3, DNMT3A and FLT3 mutation were independent adverse factors, but achieving MMR after three cycles were independent favorable factors for survival.