Blood Journal
Leading the way in experimental and clinical research in hematology

Brief report
The prognostic significance of IDH2 mutations in AML depends on the location of the mutation

  1. Claire L. Green1,
  2. Catherine M. Evans1,
  3. Lu Zhao1,
  4. Robert K. Hills2,
  5. Alan K. Burnett2,
  6. David C. Linch1, and
  7. Rosemary E. Gale1
  1. 1Department of Haematology, UCL Cancer Institute, London, United Kingdom; and
  2. 2Department of Haematology, Cardiff University School of Medicine, Cardiff, United Kingdom

Abstract

We have investigated the prognostic significance of isocitrate dehydrogenase 2 (IDH2) mutations in 1473 younger adult acute myeloid leukemia patients treated in 2 United Kingdom Medical Research Council trials. An IDH2 mutation was present in 148 cases (10%), 80% at R140 and 20% at R172. Patient characteristics and outcome differed markedly between the 2 mutations. IDH2R140 significantly correlated with nucleophosmin mutations (NPM1MUT), whereas IDH2R172 cases generally lacked other molecular mutations. An IDH2R140 mutation was an independent favorable prognostic factor for relapse (P = .004) and overall survival (P = .008), and there was no significant heterogeneity with regard to NPM1 or FLT3 internal tandem duplication (FLT3/ITD) genotype. Relapse in FLT3/ITDWTNPM1MUTIDH2R140 patients was lower than in favorable-risk cytogenetics patients in the same cohort (20% and 38% at 5 years, respectively). The presence of an IDH2R172 mutation was associated with a significantly worse outcome than IDH2R140, and relapse in FLT3/ITDWTNPM1WTIDH2R172 patients was comparable with adverse-risk cytogenetics patients (76% and 72%, respectively).

  • Submitted December 13, 2010.
  • Accepted May 1, 2011.
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