CD25 expression and outcomes in older patients with acute myelogenous leukemia treated with plerixafor and decitabine

Leuk Lymphoma. 2018 Apr;59(4):821-828. doi: 10.1080/10428194.2017.1352089. Epub 2017 Jul 18.

Abstract

We investigated CD25 expression in older (≥60 years) patients with new acute myelogenous leukemia treated with decitabine and plerixafor. Patients resistant to therapy or survival ≤1 year had significantly higher percentages of CD25pos myeloid blasts in baseline bone marrow. CD25pos patients had an increased odds of resistance compared to CD25neg patients (p = .015). In univariate analysis, we found CD25pos patients had inferior survival compared to CD25neg (p = .002). In patients with intermediate risk cytogenetics, CD25pos status stratified patients associating with inferior survival (p = .002). In multivariable analysis, CD25 and TP53 mutations trended towards predicting remission to therapy but were not predictive of survival. Only remission status, ASXL1 and TET2 mutations were found to independently predict overall survival (OS). We conclude CD25 expression identifies patients at risk for resistance to hypomethylating chemotherapy but does not independently predict OS in an older AML population treated with decitabine and plerixafor.

Trial registration: ClinicalTrials.gov NCT01352650.

Keywords: AML; CD25; decitabine; drug resistance; prognostication.

Publication types

  • Clinical Trial, Phase I
  • Clinical Trial, Phase II
  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Benzylamines
  • Bone Marrow / pathology
  • Cyclams
  • DNA Methylation / drug effects
  • DNA Methylation / genetics
  • Decitabine / pharmacology
  • Decitabine / therapeutic use*
  • Drug Resistance, Neoplasm / genetics
  • Female
  • Heterocyclic Compounds / pharmacology
  • Heterocyclic Compounds / therapeutic use*
  • Humans
  • Interleukin-2 Receptor alpha Subunit / genetics
  • Interleukin-2 Receptor alpha Subunit / metabolism*
  • Leukemia, Myeloid, Acute / drug therapy*
  • Leukemia, Myeloid, Acute / genetics
  • Leukemia, Myeloid, Acute / pathology
  • Male
  • Middle Aged
  • Mutation
  • Prognosis
  • Remission Induction / methods
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Tumor Suppressor Protein p53 / genetics

Substances

  • Benzylamines
  • Cyclams
  • Heterocyclic Compounds
  • IL2RA protein, human
  • Interleukin-2 Receptor alpha Subunit
  • TP53 protein, human
  • Tumor Suppressor Protein p53
  • Decitabine
  • plerixafor

Associated data

  • ClinicalTrials.gov/NCT01352650