Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Poor Prognostic Implication of ASXL1 Mutations in Korean Patients With Chronic Myelomonocytic Leukemia

  • Kim, Hyun-Young (Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Lee, Ki-O (Samsung Biomedical Research Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Park, Silvia (Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jang, Jun Ho (Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Jung, Chul Won (Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Sun-Hee (Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Hee-Jin (Department of Laboratory Medicine & Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2017.08.28
  • Accepted : 2018.05.21
  • Published : 2018.11.01
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Abstract

Background: Molecular genetic abnormalities are observed in over 90% of chronic myelomonocytic leukemia (CMML) cases. Recently, several studies have demonstrated the negative prognostic impact of ASXL1 mutations in CMML patients. We evaluated the prognostic impact of ASXL1 mutations and compared five CMML prognostic models in Korean patients with CMML. Methods: We analyzed data from 36 of 57 patients diagnosed as having CMML from January 2000 to March 2016. ASXL1 mutation analysis was performed by direct sequencing, and the clinical and laboratory features of patients were compared according to ASXL1 mutation status. Results: ASXL1 mutations were detected in 18 patients (50%). There were no significant differences between the clinical and laboratory characteristics of ASXL1-mutated ($ASXL1^+$) CMML and ASXL1-nonmutated ($ASXL1^-$) CMML patients (all P >0.05). During the median follow-up of 14 months (range, 0-111 months), the overall survival (OS) of $ASXL1^+$ CMML patients was significantly inferior to that of $ASXL1^-$ CMML patients with a median survival of 11 months and 19 months, respectively (log-rank P =0.049). An evaluation of OS according to the prognostic models demonstrated inferior survival in patients with a higher risk category according to the Mayo molecular model (log-rank P =0.001); the other scoring systems did not demonstrate a significant association with survival. Conclusions: We demonstrated that ASXL1 mutations, occurring in half of the Korean CMML patients examined, were associated with inferior survival. ASXL1 mutation status needs to be determined for risk stratification in CMML.

Keywords

References

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