Unveiling the Genetic and Clinical Differences of Acute Myeloid Leukemia (AML) in Obese Patients.

IF 2.3 3区 医学 Q2 HEMATOLOGY
Fevzi F Yalniz, Anna Johnson, Yanal Alnimer, Zena Chahine, Trevor Morris, Rina Yadav, Hiffsa Taj, Chaitanya Iragavarapu, Reinhold Munker, Gregory Monohan, Sainan Wai, Shulin Zhang, Sahar Nozad, Ayman Qasrawi
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引用次数: 0

Abstract

Background: The molecular architecture of acute myeloid leukemia (AML) is heterogeneous. Obesity has been identified as a risk factor for the development of AML. There remains a scarcity of data elucidating the specific genetic profile of AML in obese patients.

Methods: We conducted a review of adult patients treated at our institution for newly diagnosed AML from January 1, 2017, to January 1, 2023. Obesity is defined as BMI > 30 kg/m2. Demographic, clinical, laboratory, and pathologic data were collected retrospectively. The primary outcome of interest was the molecular features of obese compared to non-obese AML patients. The secondary outcome was overall survival (OS). Inverse probability of treatment weights (IPTW) used to balance both groups on several confounding variables.

Results: A total of 185 patients were included in the analysis. 90 (49%) were obese. Compared with non-obese patients, obese patients were younger and more likely to be females (55 vs. 63, p = 0.04, 55% vs. 38%, p value, p = 0.02, respectively). After matching on age, gender, and ethnicity, obese patients exhibit lower rates of total number of gene mutations (median 2.7 vs. 3.2, p = 0.05), significantly lower rates of mutations in transcriptional factor genes (15.7% vs. 33.2%, p = 0.01), and near-significant in spliceosome genes (12% vs. 22.3%, p = 0.08), and higher rates of NPM1 mutation (23.3% vs. 12.6%, p = 0.08). Median OS was not significantly different in the matched cohort.

Conclusions: The molecular features of obese AML patients significantly differ from non-obese counterparts. These findings suggest distinct underlying mechanisms in leukemogenesis in obese patients.

揭示肥胖患者急性髓性白血病(AML)的遗传和临床差异。
背景:急性髓性白血病(AML)的分子结构多种多样。肥胖已被确定为急性髓性白血病发病的一个危险因素。阐明肥胖患者急性髓性白血病具体遗传特征的数据仍然很少:我们对 2017 年 1 月 1 日至 2023 年 1 月 1 日期间在我院接受新诊断的急性髓细胞性白血病治疗的成年患者进行了回顾性研究。肥胖的定义是 BMI > 30 kg/m2。回顾性收集了人口统计学、临床、实验室和病理学数据。主要研究结果是肥胖急性髓细胞性白血病患者与非肥胖急性髓细胞性白血病患者相比的分子特征。次要结果是总生存期(OS)。治疗权重的逆概率(IPTW)用于平衡两组的几个混杂变量:共有 185 名患者被纳入分析。90人(49%)为肥胖。与非肥胖患者相比,肥胖患者更年轻,更可能是女性(分别为 55 对 63,P = 0.04;55% 对 38%,P 值,P = 0.02)。根据年龄、性别和种族进行匹配后,肥胖患者的基因突变总数率较低(中位 2.7 vs. 3.2,p = 0.05),转录因子基因突变率显著较低(15.7% vs. 33.2%,p = 0.01),剪接体基因突变率接近显著(12% vs. 22.3%,p = 0.08),NPM1 基因突变率较高(23.3% vs. 12.6%,p = 0.08)。匹配队列的中位OS无明显差异:结论:肥胖急性髓细胞白血病患者的分子特征与非肥胖患者有很大不同。结论:肥胖急性髓细胞性白血病患者的分子特征与非肥胖患者明显不同,这些发现表明肥胖患者白血病发生的潜在机制与非肥胖患者不同。
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来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
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