{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T16:47:44Z","timestamp":1758127664937,"version":"3.41.2"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T00:00:00Z","timestamp":1747094400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>This study aimed to evaluate the prognostic impact of methylation-related gene mutations in older patients with acute myeloid leukemia (AML).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective analysis of clinical characteristics in 645 patients aged \u2265 60\u202fyears diagnosed with AML at Fujian Medical University Union Hospital between July 2016 and December 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Methylation-related gene mutations\u2014specifically <jats:italic>DNMT3A<\/jats:italic>, <jats:italic>TET2<\/jats:italic>, <jats:italic>IDH1<\/jats:italic>, and <jats:italic>IDH2<\/jats:italic>\u2014were identified in 24.0%, 22.5%, 9.1%, and 13.8% of cases, respectively. Patients with single mutations in <jats:italic>DNMT3A<\/jats:italic> or <jats:italic>TET2<\/jats:italic> exhibited similar long-term survival outcomes compared to those without these mutations, with median survival times of 25.2 and 22.3\u202fmonths, respectively (<jats:italic>p<\/jats:italic> =\u202f0.9639). However, patients with concurrent <jats:italic>DNMT3A<\/jats:italic> and <jats:italic>TET2<\/jats:italic> mutations demonstrated the poorest treatment response and prognosis, achieving a complete remission (CR) rate of 35.5% and a median survival of only 6.2\u202fmonths. In contrast, patients with <jats:italic>IDH1<\/jats:italic>\/<jats:italic>IDH2<\/jats:italic> mutations responded better to treatment, achieving a CR rate of 69.6% and a median survival of 34.7\u202fmonths. Treatment regimens combining azacitidine and venetoclax did not provide additional improvement in treatment response for patients with methylation-related gene mutations compared to intensive chemotherapy (IC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Concurrent mutations in <jats:italic>DNMT3A<\/jats:italic> and <jats:italic>TET2<\/jats:italic> were associated with significantly poorer treatment response and survival outcomes. These common methylation-related gene mutations did not influence the choice between IC and azacitidine plus venetoclax combination therapy in elderly AML patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1594784","type":"journal-article","created":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T05:29:34Z","timestamp":1747114174000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prognostic impact of methylation-related gene mutations in elderly acute myeloid leukemia: a real-world retrospective analysis"],"prefix":"10.3389","volume":"12","author":[{"given":"Yi","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengjun","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanxin","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengyang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruyu","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1186\/s13045-020-00908-z","article-title":"The 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