Acute myeloid leukemia derived from lympho-myeloid clonal hematopoiesis
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Acute myeloid leukemia derived from lympho-myeloid clonal hematopoiesis. / Thol, F; Klesse, S; Köhler, L; Gabdoulline, R; Kloos, A; Liebich, A; Wichmann, M; Chaturvedi, A; Fabisch, J; Gaidzik, V I; Paschka, P; Bullinger, L; Bug, G; Serve, H; Göhring, G; Schlegelberger, B; Lübbert, M; Kirchner, H; Wattad, M; Kraemer, D; Hertenstein, B; Heil, G; Fiedler, W; Krauter, J; Schlenk, R F; Döhner, K; Döhner, H; Ganser, A; Heuser, M.
In: LEUKEMIA, Vol. 31, No. 6, 06.2017, p. 1286-1295.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Acute myeloid leukemia derived from lympho-myeloid clonal hematopoiesis
AU - Thol, F
AU - Klesse, S
AU - Köhler, L
AU - Gabdoulline, R
AU - Kloos, A
AU - Liebich, A
AU - Wichmann, M
AU - Chaturvedi, A
AU - Fabisch, J
AU - Gaidzik, V I
AU - Paschka, P
AU - Bullinger, L
AU - Bug, G
AU - Serve, H
AU - Göhring, G
AU - Schlegelberger, B
AU - Lübbert, M
AU - Kirchner, H
AU - Wattad, M
AU - Kraemer, D
AU - Hertenstein, B
AU - Heil, G
AU - Fiedler, W
AU - Krauter, J
AU - Schlenk, R F
AU - Döhner, K
AU - Döhner, H
AU - Ganser, A
AU - Heuser, M
PY - 2017/6
Y1 - 2017/6
N2 - We studied acute myeloid leukemia (AML) patients with lympho-myeloid clonal hematopoiesis (LM-CH), defined by the presence of DNA methyltransferase 3A (DNMT3A) mutations in both the myeloid and lymphoid T-cell compartment. Diagnostic, complete remission (CR) and relapse samples were sequenced for 34 leukemia-related genes in 171 DNMT3A mutated adult AML patients. AML with LM-CH was found in 40 patients (23%) and was associated with clonal hematopoiesis of indeterminate potential years before AML, older age, secondary AML and more frequent MDS-type co-mutations (TET2, RUNX1 and EZH2). In 82% of AML patients with LM-CH, the preleukemic clone was refractory to chemotherapy and was the founding clone for relapse. Both LM-CH and non-LM-CH MRD-positive AML patients who achieved CR had a high risk of relapse after 10 years (75% and 75%, respectively) compared with patients without clonal hematopoiesis in CR with negative MRD (27% relapse rate). Long-term survival of patients with LM-CH was only seen after allogeneic hematopoietic stem cell transplantation (HSCT). We define AML patients with LM-CH as a distinct high-risk group of AML patients that can be identified at diagnosis through mutation analysis in T cells and should be considered for HSCT.Leukemia advance online publication, 3 January 2017; doi:10.1038/leu.2016.345.
AB - We studied acute myeloid leukemia (AML) patients with lympho-myeloid clonal hematopoiesis (LM-CH), defined by the presence of DNA methyltransferase 3A (DNMT3A) mutations in both the myeloid and lymphoid T-cell compartment. Diagnostic, complete remission (CR) and relapse samples were sequenced for 34 leukemia-related genes in 171 DNMT3A mutated adult AML patients. AML with LM-CH was found in 40 patients (23%) and was associated with clonal hematopoiesis of indeterminate potential years before AML, older age, secondary AML and more frequent MDS-type co-mutations (TET2, RUNX1 and EZH2). In 82% of AML patients with LM-CH, the preleukemic clone was refractory to chemotherapy and was the founding clone for relapse. Both LM-CH and non-LM-CH MRD-positive AML patients who achieved CR had a high risk of relapse after 10 years (75% and 75%, respectively) compared with patients without clonal hematopoiesis in CR with negative MRD (27% relapse rate). Long-term survival of patients with LM-CH was only seen after allogeneic hematopoietic stem cell transplantation (HSCT). We define AML patients with LM-CH as a distinct high-risk group of AML patients that can be identified at diagnosis through mutation analysis in T cells and should be considered for HSCT.Leukemia advance online publication, 3 January 2017; doi:10.1038/leu.2016.345.
U2 - 10.1038/leu.2016.345
DO - 10.1038/leu.2016.345
M3 - SCORING: Journal article
C2 - 27881874
VL - 31
SP - 1286
EP - 1295
JO - LEUKEMIA
JF - LEUKEMIA
SN - 0887-6924
IS - 6
ER -