CEBPA are independent good prognostic factors in pediatric acute myeloid leukemia.

Abstract

To evaluate the outcome and prognostic significance of CEBPA mutations among pediatric acute myeloid leukemia (AML) from TARGET dataset. A total of 1803 pediatric patients who were diagnosed with AML were classified into two groups based on the CEBPA status by using a retrospective cohort study method from September 1996 to December 2016. The incidence of CEBPA mutations was 18%. CEBPA mutations were significantly associated with elder age (p<0.001), higher WBC (p=0.004), higher proportion of peripheral blood blast (p<0.001), normal karyotype (p<0.001), low risk (p<0.001) and higher complete remission induction rates (p<0.05). Overall, CEBPA mutations patients had a significantly better 5-year EFS (p<0.001) and OS (p<0.001) compared to CEBPA wild-type patients, and this favorable impact was maintained even in the presence of FLT3/ITD mutations. Stem cell transplantation had no significant impact on the survival of patients with coexistence of CEBPA and FLT3/ITD mutations. Multivariate analysis demonstrated that mutated CEBPA were an independent favorable indicators of better outcome in terms of EFS (p=0.007) and OS (p=0.039). Our study demonstrate mutated CEBPA have an excellent outcome in pediatric AML patients. Furthermore, pediatric AML patients with coexistence of CEBPA and FLT3/ITD mutation appear to have favorable prognoses and might not required stem cell transplantation.