TY - JOUR
T1 - Only SF3B1 mutation involving K700E independently predicts overall survival in myelodysplastic syndromes
AU - Kanagal-Shamanna, Rashmi
AU - Montalban-Bravo, Guillermo
AU - Sasaki, Koji
AU - Darbaniyan, Faezeh
AU - Jabbour, Elias
AU - Bueso-Ramos, Carlos
AU - Wei, Yue
AU - Chien, Kelly
AU - Kadia, Tapan
AU - Ravandi, Farhad
AU - Borthakur, Gautam
AU - Soltysiak, Kelly A.
AU - Routbort, Mark
AU - Patel, Keyur
AU - Pierce, Sherry
AU - Medeiros, L. Jeffrey
AU - Kantarjian, Hagop M.
AU - Garcia-Manero, Guillermo
N1 - Funding Information:
This work was supported in part by grants from the Ladies Leukemia League and leukemia SPORE career enhancement award (to Rashmi Kanagal‐Shamanna), the National Cancer Institute of the National Institutes of Health (University of Texas MD Anderson Cancer Center Support Award CA016672 [all authors]), and the University of Texas MD Anderson MDS/AML Moon Shot (to Yue Wei, Kelly A. Soltysiak, Faezeh Darbaniyan, Hagop Kantarjian, and Guillermo Garcia‐Manero).
Funding Information:
Koji Sasaki reports grants from Novartis (to his institution); consulting fees from Daiichi‐Sankyo, Novartis, and Pfizer Japan; and payments or honoraria from Otsuka. Elias Jabbour reports research support from and advisory roles with Adaptive, AbbVie, Amgen, Pfizer, Cyclacel, Takeda, and Bristol‐Myers Squibb. Tapan Kadia reports grants or contracts from AbbVie, Agios, Amgen, Genentech, Daiichi Sankyo, Jazz, Novartis, Pfizer, and Sanofi‐Aventis; consulting fees from AbbVie, Agios, Genentech, Jazz, Pfizer, PulmoTech, Cellenkos, Ascentage, Genfleet, Astellas, and AstraZeneca; and payments or honoraria from Cure and Genzyme. Hagop Kantarjian reports research support from and an advisory role with Actinium; research support from AbbVie, Agio, Amgen, Ariad, Ascentage, Astex, Bristol‐Myers Squibb, Cyclacel, Daiichi‐Sankyo, Immunogen, Jazz Pharma, Novartis, Sanofi, and Pfizer; and honoraria from AbbVie, Adaptive Biotechnologies, Amgen, Aptitude Health, BioAscend, Daiichi‐Sankyo, Delta Fly, Janssen Global, Novartis, Oxford Biomedical, Pfizer, and Takeda Oncology. Guillermo Garcia‐Manero reports research support from and advisory roles with Bristol‐Myers Squibb, Astex, and Helsinn; research support from Curis, Janssen, Genentech, Forty Seven, Aprea, Amphivena, Novartis, AbbVie, H3 Biomedicine, Onconova, and Merck; and consulting fees from Bristol‐Myers Squibb, Astex, Helsinn, and Genentech. The other authors made no disclosures.
Publisher Copyright:
© 2021 American Cancer Society.
PY - 2021/10/1
Y1 - 2021/10/1
N2 - Background: SF3B1 mutations (SF3B1mut) in myelodysplastic syndromes (MDS) frequently involve codon K700E and have a favorable prognosis. The prognostic effect of non-K700E SF3B1mut is uncertain. Methods: The authors analyzed the clinicopathological features and outcomes of a single-institution series of 94 treatment-naive SF3B1mut MDS patients (18%) and 415 treatment-naive SF3B1wt MDS patients and explored the differences between K700E and non-K700E SF3B1mut MDS. Results: Fifty-five patients (59%) carried K700E. Recurrent non-K700E mutations (39 [41%]) included R625, H662, and K666. Compared with SF3B1mut K700E patients, non-K700E patients had a lower median absolute neutrophil count (1.8 vs 2.4; P =.005) and were frequently “high” according to the Revised International Prognostic Scoring System (19% vs 4%; P =.031). Non-K700E MDS was associated frequently with RUNX1 (26% vs 7%; P =.012) and exclusively with BCOR, IDH2, and SRSF2 mutations. A splicing analysis showed the differential distribution of alternatively spliced events and gene expression profiles between K700 and non-K700E MDS patients. The majority (at least 80%) of SF3B1mut K700E, SF3B1mut non-K700E, and SF3B1wt patients were treated with hypomethylating agents. Over a median follow-up of 16 months, SF3B1mut had superior overall survival (OS) in comparison with SF3B1wt in all MDS patients (not reached vs 25.2 months; P =.0003), in patients with low-grade MDS, and in patients with myelodysplastic syndromes with ring sideroblasts (MDS-RS). Compared with SF3B1wt, SF3B1mut K700E had superior outcomes in all MDS (median OS, 25 months vs not reached; P =.0001), in low-grade MDS (median OS, 41.3 months vs not reached; P =.0015), and in MDS-RS (median OS, 22.3 months vs not reached; P =.0001), but no significant difference was seen between non-K700E and SF3B1wt MDS. By multivariable analysis, the absence of SF3B1mut K700E mutations was independently associated with the prognosis. Conclusions: This study highlights the importance of the SF3B1 mutation subtype in MDS risk assessment. Lay Summary: Myelodysplastic syndromes (MDS) with SF3B1 mutations are regarded as having a favorable prognosis by both the World Health Organization and the International Working Group for the Prognosis of Myelodysplastic Syndromes. However, this article shows that only MDS patients with SF3B1 K700E mutations have a favorable prognosis (and not MDS patients with SF3B1 mutations involving other codons). This has important implications for refining future MDS subclassification and risk assessment criteria.
AB - Background: SF3B1 mutations (SF3B1mut) in myelodysplastic syndromes (MDS) frequently involve codon K700E and have a favorable prognosis. The prognostic effect of non-K700E SF3B1mut is uncertain. Methods: The authors analyzed the clinicopathological features and outcomes of a single-institution series of 94 treatment-naive SF3B1mut MDS patients (18%) and 415 treatment-naive SF3B1wt MDS patients and explored the differences between K700E and non-K700E SF3B1mut MDS. Results: Fifty-five patients (59%) carried K700E. Recurrent non-K700E mutations (39 [41%]) included R625, H662, and K666. Compared with SF3B1mut K700E patients, non-K700E patients had a lower median absolute neutrophil count (1.8 vs 2.4; P =.005) and were frequently “high” according to the Revised International Prognostic Scoring System (19% vs 4%; P =.031). Non-K700E MDS was associated frequently with RUNX1 (26% vs 7%; P =.012) and exclusively with BCOR, IDH2, and SRSF2 mutations. A splicing analysis showed the differential distribution of alternatively spliced events and gene expression profiles between K700 and non-K700E MDS patients. The majority (at least 80%) of SF3B1mut K700E, SF3B1mut non-K700E, and SF3B1wt patients were treated with hypomethylating agents. Over a median follow-up of 16 months, SF3B1mut had superior overall survival (OS) in comparison with SF3B1wt in all MDS patients (not reached vs 25.2 months; P =.0003), in patients with low-grade MDS, and in patients with myelodysplastic syndromes with ring sideroblasts (MDS-RS). Compared with SF3B1wt, SF3B1mut K700E had superior outcomes in all MDS (median OS, 25 months vs not reached; P =.0001), in low-grade MDS (median OS, 41.3 months vs not reached; P =.0015), and in MDS-RS (median OS, 22.3 months vs not reached; P =.0001), but no significant difference was seen between non-K700E and SF3B1wt MDS. By multivariable analysis, the absence of SF3B1mut K700E mutations was independently associated with the prognosis. Conclusions: This study highlights the importance of the SF3B1 mutation subtype in MDS risk assessment. Lay Summary: Myelodysplastic syndromes (MDS) with SF3B1 mutations are regarded as having a favorable prognosis by both the World Health Organization and the International Working Group for the Prognosis of Myelodysplastic Syndromes. However, this article shows that only MDS patients with SF3B1 K700E mutations have a favorable prognosis (and not MDS patients with SF3B1 mutations involving other codons). This has important implications for refining future MDS subclassification and risk assessment criteria.
KW - K700E
KW - SF3B1
KW - myelodysplastic syndromes
KW - prognosis
KW - ring sideroblasts
UR - http://www.scopus.com/inward/record.url?scp=85108338633&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85108338633&partnerID=8YFLogxK
U2 - 10.1002/cncr.33745
DO - 10.1002/cncr.33745
M3 - Article
C2 - 34161603
AN - SCOPUS:85108338633
SN - 0008-543X
VL - 127
SP - 3552
EP - 3565
JO - Cancer
JF - Cancer
IS - 19
ER -