title: Impact of TET2 mutations on response rate to azacitidine in myelodysplastic syndromes and low blast count acute myeloid leukemias.
abstract: The impact of ten-eleven-translocation 2 (TET2) mutations on response to azacitidine (AZA) in MDS has not been reported. We sequenced the TET2 gene in 86 MDS and acute myeloid leukemia (AML) with 20-30% blasts treated by AZA, that is disease categories wherein this drug is approved by Food and Drug Administration (FDA). Thirteen patients (15%) carried TET2 mutations. Patients with mutated and wild-type (WT) TET2 had mostly comparable pretreatment characteristics, except for lower hemoglobin, better cytogenetic risk and longer MDS duration before AZA in TET2 mutated patients (P=0.03, P=0.047 and P=0.048, respectively). The response rate (including hematological improvement) was 82% in MUT versus 45% in WT patients (P=0.007). Mutated TET2 (P=0.04) and favorable cytogenetic risk (intermediate risk: P=0.04, poor risk: P=0.048 compared with good risk) independently predicted a higher response rate. Response duration and overall survival were, however, comparable in the MUT and WT groups. In higher risk MDS and AML with low blast count, TET2 status may be a genetic predictor of response to AZA, independently of karyotype.
authors.affiliation: Service d'Hématologie Clinique Hôpital Avicenne, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris 13, Bobigny, France.
authors.forename: R
authors.initials: R
authors.lastname: Itzykson
authors.forename: O
authors.initials: O
authors.lastname: Kosmider
authors.forename: T
authors.initials: T
authors.lastname: Cluzeau
authors.forename: V
authors.initials: V
authors.lastname: Mansat-De Mas
authors.forename: F
authors.initials: F
authors.lastname: Dreyfus
authors.forename: O
authors.initials: O
authors.lastname: Beyne-Rauzy
authors.forename: B
authors.initials: B
authors.lastname: Quesnel
authors.forename: N
authors.initials: N
authors.lastname: Vey
authors.forename: V
authors.initials: V
authors.lastname: Gelsi-Boyer
authors.forename: S
authors.initials: S
authors.lastname: Raynaud
authors.forename: C
authors.initials: C
authors.lastname: Preudhomme
authors.forename: L
authors.initials: L
authors.lastname: Adès
authors.forename: P
authors.initials: P
authors.lastname: Fenaux
authors.forename: M
authors.initials: M
authors.lastname: Fontenay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001374:Azacitidine / Q000627:therapeutic use*; D019175:DNA Methylation / Q000187:drug effects; D004273:DNA, Neoplasm / Q000235:genetics; D004268:DNA-Binding Proteins / Q000235:genetics* / Q000502:physiology; D049308:Dioxygenases; D018572:Disease-Free Survival; D005260:Female; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D053208:Kaplan-Meier Estimate; D007621:Karyotyping; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009190:Myelodysplastic Syndromes / Q000097:blood / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D009363:Neoplasm Proteins / Q000235:genetics* / Q000502:physiology; D011518:Proto-Oncogene Proteins / Q000235:genetics* / Q000502:physiology; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D004273:DNA, Neoplasm; D004268:DNA-Binding Proteins; D006454:Hemoglobins; D009363:Neoplasm Proteins; D011518:Proto-Oncogene Proteins; D049308:Dioxygenases; C541081:TET2 protein, human; D001374:Azacitidine