AUTHOR=Bai Yanliang , Sun Xiaobai , Li Mengyi , Niu Xiaona , Cao Weijie , Niu Junwei , Xiao Xingjun , Chen Yuqing , Sun Kai 

TITLE=CD7-positive leukemic blasts with DNMT3A mutations predict poor prognosis in patients with acute myeloid leukemia

JOURNAL=Frontiers in Oncology

VOLUME=14

YEAR=2024

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2024.1342998

DOI=10.3389/fonc.2024.1342998

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p><italic>DNMT3A</italic> mutations can be detected in premalignant hematopoietic stem cells and are primarily associated with clonal hematopoiesis of indeterminate potential; however, current evidence does not support assigning them to a distinct European Leukemia Net (ELN) prognostic risk stratification. CD7 is a lymphoid antigen expressed on blasts in approximately 30% of acute myeloid leukemia (AML), and its role in AML remains unclear and depends on subgroup evaluation. This study investigated the prognostic value of <italic>DNMT3A</italic> mutation combined with CD7 expression in AML.</p></sec><sec><title>Methods</title><p>We retrospectively analyzed the clinical data of 297 newly diagnosed non-M3 AML patients. According to the <italic>DNMT3A</italic> mutation and CD7 expression in AML cells, patients were divided into the <italic>DNMT3A</italic>-mutated/CD7-positive (CD7+), <italic>DNMT3A</italic>-mutated/CD7-negative (CD7-), <italic>DNMT3A</italic>-wild-type/CD7+, and <italic>DNMT3A</italic>-wild-type/CD7- groups.</p></sec><sec><title>Results</title><p>The <italic>DNMT3A</italic>-mutated/CD7+ group had lower complete remission rates and higher relapse rates. Importantly, these patients had significantly shorter overall survival (OS) and relapse-free survival (RFS). Furthermore, multivariate analysis showed that CD7+ with <italic>DNMT3A</italic> mutation was an independent risk factor for OS and RFS.</p></sec><sec><title>Conclusion</title><p>CD7+ with <italic>DNMT3A</italic> mutation predicts a poor prognosis in AML patients, and the immunophenotype combined with molecular genetic markers can help to further refine the current risk stratification of AML.</p></sec>