The prognostic value of IDH1 and IDH2 in acute myeloid leukemia (AML)

Felicitas Thol, MD, from Hannover Medical School, Hannover, Germany, discusses the prognostic value of IDH1 and IDH2 mutations in acute myeloid leukemia (AML) at the International Symposium on Acute Leukemias (ISAL) 2017 in Munich, Germany. She explains that IDH1 and IDH2 mutations are most commonly found in patients with cytogenetically normal AML, and are typically observed in older patients with lower white blood cell and higher platelet counts. Interestingly, Dr Thol describes how IDH1 and IDH2 mutations are also more common in patients with NPM1 mutations. It is a matter of debate whether IDH1 and IDH2 have a prognostic impact, with studies showing both positive and negative prognostic impacts of IDH mutations in certain subgroups, such as patients with NPM1. Since the discovery of the IDH mutations, other mutations in AML have come to light, which should also be taken into account. Dr Thol states that IDH2 mutations in codon R172 have been found in a collaborative study between the Sanger Institute and the AML Study Group (AMLSG) to have a favorable prognostic impact. In addition, gene-gene interactions may play a role, with some indications that IDH2 mutations on codon R140 in combination with Dnmt3a mutations have a negative prognostic impact. However, she concludes that it is difficult to make a clear statement what the prognostic impact of IDH mutations is, with the exception of IDH2 mutations at codon R172.

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