Prognostic value of ASXL1 mutations in acute myeloid leukemia: A meta-analysis

Objectives: Mutations in ASXL1 are being investigated for prognostic value in AML, but the relationship between these mutations and prognosis for patients with AML remains unclear. Therefore, we are conducting a meta-analysis to estimate the effect of mutations in ASXL1 to determine their prognostic significance.

Methods: Eight studies were selected by searching PubMed, Embase, Web of Science, ClinicalTrials, and the Cochrane Library databases. Hazard ratios (HRs) and their 95% confidence intervals (CIs) for overall survival (OS) and event-free survival (EFS) were pooled to assess the effect of ASXL1 mutations on the prognosis in AML patients.

Results: A total of 8 studies with 4143 patients were included in this meta-analysis. The pooled HRs for OS and EFS revealed that AML patients with ASXL1 mutations had a significantly poor prognosis as compared with those without mutations (OS: HR = 1.59, 95% CI = 1.34-1.88, p < 0.00001; EFS: HR = 1.63, 95% CI = 1.27-2.08, p < 0.0001). Mutations in ASXL1 showed no strong relationship with other AML-specific mutations and FAB subtypes.

Discussion: This meta-analysis showed that AML patients with ASXL1 mutations had a poor prognosis, which may be a reason to include the diagnostics of this mutation in the prognostic scales for assessing risk in patients with AML.