Prognosis of RUNX1-RUNX1T1 Rearrangement in Newly Diagnosed Acute Myeloid Leukemia Patients

Abstract

Objective: To compare the clinical-hematological (including laboratory and morphological) parameters of newly diagnosed AML patients with RUNX1-RUNX1T1 rearrangement before and after induction therapy. Study Design and Setting: This is a cross-sectional study, Department of Hematology, Armed Forces Institute of Pathology (AFIP), Rawalpindi from December 2021 to December 2022. Methodology: 64 newly diagnosed patients with de novo t (8;21) AML were included. The RUNX1-RUNX1T1 fusion gene was detected using real-time reverse transcriptase polymerase chain reaction (RT-PCR); while t(8;21) was identified through chromosomal/cytogenetic analysis. All the clinical parameters, laboratory variables, blast percentages, and morphological parameters of newly diagnosed AML RUNX1-RUNX1T1 patients were compared before and after therapy. AML induction regimen included the following drugs: cytarabine along daunorubicin. Assessment of these patients was carried out four weeks after induction therapy. Results: The patients' mean age was 60 (ranging from 14 to 85 years), with 46 males and 18 females. Statistical significance was observed in TLC (p-value < 0.001), Hb (p= 0.001), and platelet count(p=0.001) levels. After treatment, the blast size in peripheral blood was reduced to zero and both Auer rods and abnormal granules were absent in bone marrow blasts of patients. The average percentage of eosinophilia decreased from 8.52±1.76 before treatment to 2.42±1.79 after treatment. Conclusions: Our study concluded that the treatment approach(cytarabine along with daunorubicin or idarubicin) for patients with RUNX1-RUNX1T1 AML resulted in improved blood counts, reduced blast cells, Auer rods, and abnormal granules; with a higher rate of complete remission and a lower incidence of relapse.