More precise risk stratification for de novo acute myeloid leukemia with double-mutation CEBPA.

BACKGROUND: CEBPA double-mutation (CEBPAdm) defines a favorable-risk subgroup of acute myeloid leukemia (AML), but marked heterogeneity exists, and relapse remains common. More precise prognostic stratification is urgently needed for this population. OBJECTIVES: To identify reliable prognostic factors and establish a refined risk stratification model for de novo AML with CEBPAdm. DESIGN: Single-center retrospective observational cohort study. METHODS: Samples were collected from AML patients at diagnosis for analysis. The proportions of different surface antigens in the bone marrow were evaluated via flow cytometry. The detection of mutations in AML patients was based on next-generation sequencing (NGS). Multiparametric flow cytometry (MFC) can detect minimal residual disease (MRD). The data were analysed via Statistical Program for Social Sciences Version 27.0 (SPSS 27.0). RESULTS: ①Univariate analysis revealed that high expression of cluster of differentiation antigen 33 (CD33)was unfavourable prognostic factor (P=0.028). ②There was a statistically significant difference between patients with more than 2 companion gene mutations (χ2=9.868, P=0.002). ③Notably, patients who became MRD-negative after induction chemotherapy had more favourable outcomes (χ2=3.847, P=0.05). ④Overall survival (OS) was worse in the high expression of CD33 group (43.00 months vs. 39.00 months, Log Rank P=0.024). CONCLUSIONS: These findings provide a more precise restratification for CEBPAdm patients on the basis of the expression of CD33.