GSE208218
The transcriptomic landscape of elderly acute myeloid lekiemia identifies B7H3 and BANP as a new favorable signature in high-risk patients
Acute myeloid leukemia (AML) in the elderly remains a clinical challenge, with a five-year overall survival less than 10%. The current ELN 2017 genetic risk classification considers cytogenetic and mutational characteristics to stratify fit AML patients into different prognostic groups. However, this classification is not validated for elderly patients treated with a non-intensive approach, and its performance seems to be suboptimal in this context. Indeed, the transcriptomic landscape of AML in the elderly has been less explored and it might help stratify this group of patients. In the current study, we analyzed the transcriptome of 224 AML patients > 65 years-old at diagnosis treated in the Spanish PETHEMA-FLUGAZA clinical trial and tried to define new prognostic groups in this population. We identified a specific transcriptomic signature for high-risk patients with mutated p53 or complex karyotype, revealing that low expression of B7H3 gene with high expression of BANP gene distinguish a subset of AML patients surviving more than 12 months. This specific signature highlights the potential of transcriptomics to identify biomarkers of good prognosis in elderly AML and recognizes these two genes as possible therapeutic targets in this malignancy. Overall design: Gene expression analysis of RNAseq data of elderly patients with AML at diagnosis treated in the Spanish PETHEMA-FLUGAZA clinical trial.