MECOM Rearrangements in AML: What Patients Need to Know | Jesus Gonzales Lugo, MD

My name is Jesus Gonzalez Lugo. I am at the University of Kansas Cancer Center and I treat leukemia and MDS. And I'm here to talk to you about my oral presentation here at ASH 2025. I talked about outcomes in mycombrie-arranged acute myeloid leukemia. Mycombrie-arranged acute myeloid leukemia is a rare subtype of acute myeloid leukemia which is present in about 2-4% of the patients. We know that patients when they receive intensive chemotherapy, they do poorly. And it is not known and there is not a lot of data for patients when they receive lower intensity treatments. For example, patients that receive hypomethylating agents or hypomethylating agents alone such as isocytidine, isocytidine venetoclax. So that is not something that is, there is a lot of data there. So that is what, that was the impetus for doing our study. And what we did is that we did a multi-center retrospective study and utilizing two databases. We utilized a flat iron database which contains information about cancer centers and community centers and we used the MARO consortium database which contains information about 10 cancer centers. And we looked at outcomes for those patients. We analyzed 224 patients. Then the majority of the patients were older than 65 years and the majority of the patients actually had good performance data so they were fit for receiving chemotherapy. What we found is that the median survival for the patients receiving, well first of all, what we found is that patients that had MECOM rearranged AML, their overall survival which is the median overall survival unfortunately is not very good across the board, is about 10 months. And we found that if we divided that by treatments that the patients received, so patients that received intensive chemotherapy, this being 7 plus 3 which is donor-rubicin, which is something called CPX, the median survival was 15 months compared to patients that received lower intensity treatments that the median survival for example patients that received venetoclax and hypomethylating agents was 9 months and when they received hypomethylating agents alone it was about 6 months. The other thing that we found is that the median survival for the patients that received lower intensity treatments was 26 months. The other thing that we found is that patients that were able to get to an allogeneic stem cell transplant, those were the patients that we found had also better median overall survival. So the median overall survival for those patients actually was 26 months and there was no difference in the treatment that they had received. If they received lower intensity treatments or intensity treatments there was no difference. So our conclusion with this study even though it's limited because it was retrospective data is that patients that can get to a transplant and are fit enough to do this, they should get to a transplant because those are the patients that actually can have the longer survival with this very bad subtype of disease and we definitely need more research into this because we don't have anything targeted targeting this mutation right now or this rearrangement I should say and we really need much more to know about this disease. So thank you very much. If our videos have helped you in any way and you're able to please consider making a donation to help us continue this important work. Your gift will go three times as far when we reach $500,000 by the end of the year. Every contribution, big or small, makes a difference and we're deeply grateful for your support.