Prognostic Significance Of RUNX1 Mutations In Acute Myeloid Leukemia:a Meta-analysis

Objectives Increasing number of studies suggested that RUNX1 mutations associated with unfavorable prognosis in patients with acute myeloid leukemia(AML),but the results remain controversial.Therefore,We conduct a meta-analysis to evaluate the impact of RUNX1 mutations on patients with AML.Methods a comprehensive literature search was undertaken on Pub Med,EMBASE and Cochrane Library databases through February 2018 looking for eligible studies.We calculate the combined risk ratios(RRs)and 95% confidence intervals(95%CIs)to find the relationship between RUNX1 mutation and the other mutations.Pooled odds ratios(ORs)estimates and 95% CIs in complete remission rate(CR)were used to calculate estimated effect.Pooled hazard ratios(HRs)and 95% CIs in overall survival(OS),event-free survival(EFS),relapse-free survival(RFS)were retrieved to evaluate the prognostic impact of RUNX1 mutations in AML.Results Eleven studies covering a total of 5915 subjects were selected for this meta-analysis.RUNX1 mutations were significantly associated with older age(P< 0.000),and always cocurrent with ASXL1 mutations(RR: 3.26,95%CI: 2.69-3.95;P=0.000)neither NPM1 mutations or CEBPA mutations.Cytogenetically normal(CN-AML)patients with RUNX1 mutation have lower CR(OR: 0.59,95%CI: 0.47-0.75).RUNX1 mutations were associated with unfavorable OS and EFS in patients with AML(HR for OS: 1.44,95%CI: 1.15-1.80;HR for EFS: 1.25,95%CI: 1.08-1.45),but nor RFS(HR: 1.45,95%CI: 0.87-2.41).Conclusion RUNX1 mutations were associated with poor prognosis in AML,which may contribute to risk stratification and prognostic assessment in the disease.In future,it may become a new theraputic target of AML.