Clinical Outcomes of Acute Myeloid Leukemia Patients Harboring the RUNX1 Mutation: Is It Still an Unfavorable Prognosis? A Cohort Study and Meta-Analysis.

Acute myeloid leukemia (AML) with mutated RUNX1 ( RUNX1 mut ) is considered to have an unfavorable prognosis. However, recent studies have reported comparable survival outcomes with wild-type RUNX1 ( RUNX1 wt ). To assess the clinical outcomes of AML with and without RUNX1 mut , we performed a prospective cohort study and systematic review and meta-analysis. The study enrolled 135 patients (27 with RUNX1 mut ; 108 with RUNX1 w t ). There were no significant differences in the median OS and RFS of the RUNX1 mut and RUNX1 wt groups (9.1 vs. 12.2 months; p = 0.268 and 7.8 vs. 14.6 months; p = 0.481, respectively). A subgroup analysis of de novo AML patients with intermediate-risk cytogenetics showed similar outcomes. Our meta-analysis pooled data from 23 studies and our study. The complete remission rate was significantly lower in the RUNX1 mut group (pooled odds ratio: 0.42). The OS, RFS, and event-free survival rates also favored the RUNX1 wt group (pooled risk ratios: 1.36, 1.37, and 1.37, respectively). A subgroup analysis of de novo AML patients with intermediate-risk cytogenetics demonstrated nearly identical OS and RFS outcomes. This study confirms that patients with AML and RUNX1 mut had poor prognoses. Nonetheless, in de novo AML with intermediate-risk cytogenetics, the survival outcomes of both groups were comparable.