Frequency and prognostic significance of RAS pathway alterations in adult acute lymphoblastic leukemia.

RAS pathway alterations play an important role in the development and progression of hematological malignancies. However, their frequency and clinical significance in adult ALL remain poorly investigated and not well defined. In this study, we analyzed the frequency and prognostic significance of RAS pathway alterations in newly diagnosed adult ALL patients. Among the 387 patients, RAS pathway alterations were detected in 52 (13.4 %). Multivariate analysis identified these alterations as independent predictors of poor overall survival (OS) and event-free survival (EFS) (OS, P = 0.046; EFS, P = 0.004). Kaplan-Meier survival analysis revealed that patients with PTPN11 mutations had poorer OS (P = 0.029) than those without PTPN11 mutations. Patients with KRAS mutations had inferior OS and EFS compared to those without KRAS mutations (P = 0.021; 0.0017). These findings suggest that analysis of RAS pathway alterations may enable more accurate prognostic stratification of adult ALL patients.