Clinical Characteristics and Chemotherapy Regimen of AML Patients with EVI1 Overexpression and Intolerance to Enhanced Chemotherapy

WANG Xuan; GUO Shuxia; ZHANG Xiaojuan; QIN Na; SHI Ruiping; CHEN Xinghua; WANG Yanmei; CHEN Ronghua; ZHANG Yue; FAN Wei

doi:10.3969/j.issn.1004-437X.2025.23.002

Abstract：Objective To explore the clinical characteristics and chemotherapy regimen of patients with acute myeloid leukemia(AML)who were intolerant to enhanced chemotherapy and have high expression of ecotropic viral integration site 1(EVI1).Methods A retrospective study method was conducted,42 patients with EVI1 high expression AML who were tolerant to intensive chemotherapy and treated in Zhengzhou People's Hospital from January 2018 to January 2023 were selected as the observation group,while 60 patients with EVI1 low expression AML who were tolerant to intensive chemotherapy were selected as the control group.Hemoglobin,blood platelet count,FAB typing,cytogenetics,chemotherapy regimen,efficacy,and median overall survival time were compared between the two groups.Results There were no differences in hemoglobin and platelets between the observation group and the control group(P＞0.05).There was difference in FAB typing between the observation group and the control group(P＜0.05),with a higher proportion of M4 and M5 in the observation group,reaching 42.86％and 28.57％,respectively.The proportion of normal karyotype and karyotype t(8,21)in the observation group was 21.43％and 4.76％,respectively,which were lower than that in the control group(P＜0.05).The proportions of karyotypes 11q23,inv(3)/t(3;3),and monomer 7(-7)in the observation group were 33.33％,23.81％,and 16.67％,respectively,which were higher than those in the control group(P＜0.05).There were no differences in the proportion oft(15;17)and inv(16)between the observation group and the control group(P＞0.05).There was no difference in the chemotherapy regimen between the observation group and the control group(P＞0.05).The complete response(CR)rate in the observation group was 45.24％,which was lower than that in the control group(P＜0.05).The median overall survival time of the observation group was 17 months(95％CI:13.53-20.47),which was lower than that of the control group(P＜0.05).The CR rate of the observation group's hypomethylating agents(HMA)+venetoclax(VEN)combined with all-trans retinoic acid(ATRA)+arsenic trioxide chemotherapy regimen was 63.64％,which was higher than that of HMA+VEN chemotherapy regimen(P＜0.05).Conclusion The chemotherapy effect and prognosis of AML patients with high expression of EVI1 who are intolerant to enhanced chemotherapy are poor,the proportion of M4 and M5 in FAB classification is high,and the chromosome karyotypes are mainly poor prognosis 11 q23,inv(3)/t(3;3)etc.The chemotherapy regimen of HMA+VEN combined with ATRA and arsenic tri oxide is effective for patients.