Mecom Fusion Partner and Bone Marrow Blast Percentage Influence Outcomes of Patients With Mecom Rearranged Acute Myeloid Leukaemia

Authors

Wei-Ying Jen
Guilin Tang
Eitan Kugler
Jennifer Croden
Koji Sasaki
Alexandre Bazinet
Alex Bataller
Guillermo Montalban-Bravo
Gautam Borthakur
Gokce A Toruner
Sanam Loghavi
Nicholas J Short
Ghayas C Issa
Ian M Bouligny
Sherry Pierce
Uday Popat
Naveen Pemmaraju
Elias Jabbour
Guillermo Garcia-Manero
Kapil Bhalla
Farhad Ravandi
Naval G Daver
Courtney D DiNardo
Hagop M Kantarjian
Tapan M Kadia

Language

English

Publication Date

12-1-2025

Journal

British Journal of Haematology

DOI

10.1111/bjh.70171

PMID

40983567

PMCID

PMC12490727

PubMedCentral® Posted Date

10-3-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

MECOM rearrangements (MECOM-r) are acute myeloid leukaemia (AML)-defining, regardless of blast percentage or MECOM fusion partner. We sought to investigate if blast percentage or MECOM-r partner was associated with overall survival (OS). We included 152 adult patients with newly diagnosed MECOM-r and classified blast percentage into < 20% or ≥20% and MECOM-r partner into classic (GATA2::MECOM) or variant (others). Thirty-one per cent had < 20% blasts, with 69% having ≥20%; 57% had classic and 43% variant MECOM-r. Treatment was with intensive chemotherapy (IC) in 41% and low-intensity therapy (LIT) in 59%. Composite complete remission rates were similar between IC (50%) and LIT (48%, p = 0.99). The median OS was 17 months (95% confidence interval [CI], 12-not estimable [NE]) for < 20% blasts, compared with 9 months (95% CI, 6-10) for ≥20% blasts (p <  0.01). On multivariate analysis, ≥20% blasts were associated with worse OS (hazard ratio [HR] 1.9, [95% CI, 1.2-3.2], p <  0.01), independent of age, MECOM-r partner, additional cytogenetic abnormalities, treatment intensity, addition of venetoclax and stem cell transplant (SCT). HR for IC was 2.0 (95% CI, 1.1-3.7, p = 0.03). In < 20% blasts, variant MECOM-r was independently associated with a reduced hazard of death (HR 0.2 [95% CI, 0.1-0.8], p <  0.01). MECOM-r AML is a heterogenous entity; consideration should be given to LIT approaches.

Keywords

Humans, Leukemia, Myeloid, Acute, Male, Female, Middle Aged, Adult, Aged, Oncogene Proteins, Fusion, Bone Marrow, Young Adult, Aged, 80 and over, Adolescent, Blast Crisis, Gene Rearrangement, Treatment Outcome, AML, atypical MECOM, inv(3)(q21.3q26.2), t(3;3)(q21.3;q26.2), variant MECOM

Published Open-Access

yes

Recommended Citation

Jen, Wei-Ying; Tang, Guilin; Kugler, Eitan; et al., "Mecom Fusion Partner and Bone Marrow Blast Percentage Influence Outcomes of Patients With Mecom Rearranged Acute Myeloid Leukaemia" (2025). Faculty, Staff and Student Publications. 5588.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/5588