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We aimed to evaluate the prognostic impact of RUNX1 mutations following allogeneic hematopoietic stem cell transplantation (allo-HSCT) by comparing clinical outcomes in AML patients with and without RUNX1 mutations. We retrospectively analyzed 91 AML patients (33 RUNX1+ and 58 RUNX1\u2212) who received their first HSCT at Peking University People\u2019s Hospital. The median age of the cohort was 38 years (range: 6\u201364), with 73 patients (80%) receiving Haploidentical HSCT and 18 patients (20%) receiving sibling-matched allo-HSCT. In univariate analyses, no significant differences in survival outcomes were observed. For the RUNX1-mutation group and RUNX1-wild-type group, the 2-year cumulative incidence of relapse (CIR) was (12.6% vs. 7.6%, p = 0.472), the 2-year non-relapse mortality (NRM) rate was (9.6% vs. 7.2%, p = 0.747), the 2-year LFS was (77.8% vs. 85.2%, p = 0.426), and the 2-year OS rate was (85.9% vs. 92.7%, p = 0.397). We did not observe any negative impact of RUNX1 mutations on clinical outcomes, suggesting that allo-HSCT (especially Haplo-HSCT) may mitigate the adverse prognostic influence of RUNX1 mutations in AML.<\/jats:p>","DOI":"10.3390\/curroncol32060294","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T07:04:28Z","timestamp":1747897468000},"page":"294","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Effects of RUNX1 Mutations on the Outcomes of Patients with Acute Myeloid Leukemia Treated with Allogeneic Hematopoietic Stem-Cell Transplantation"],"prefix":"10.3390","volume":"32","author":[{"given":"Wei-Jie","family":"Ran","sequence":"first","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan-Ping","family":"Xu","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Hui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-6050","authenticated-orcid":false,"given":"Ying-Jun","family":"Chang","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Dong","family":"Mo","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Qian","family":"Sun","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Jun","family":"Huang","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Wang","sequence":"additional","affiliation":[{"name":"Peking University People\u2019s Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Collaborative Innovation Center of Hematology, Peking University, Beijing 100044, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2070","DOI":"10.1182\/blood-2016-10-687830","article-title":"Role of RUNX1 in Hematological Malignancies","volume":"129","author":"Sood","year":"2017","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1038\/nrc3877","article-title":"The RUNX Family: Developmental Regulators in Cancer","volume":"15","author":"Ito","year":"2015","journal-title":"Nat. Rev. Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"5352","DOI":"10.1182\/blood-2009-05-223784","article-title":"AML1\/RUNX1 Mutations in 470 Adult Patients with de Novo Acute Myeloid Leukemia: Prognostic Implication and Interaction with Other Gene Alterations","volume":"114","author":"Tang","year":"2009","journal-title":"Blood"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.3324\/haematol.2012.064667","article-title":"RUNX1 Mutations in Cytogenetically Normal Acute Myeloid Leukemia Are Associated with a Poor Prognosis and Up-Regulation of Lymphoid Genes","volume":"97","author":"Greif","year":"2012","journal-title":"Haematologica"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1200\/JCO.2010.30.7926","article-title":"RUNX1 Mutations in Acute Myeloid Leukemia: Results From a Comprehensive Genetic and Clinical Analysis From the AML Study Group","volume":"29","author":"Gaidzik","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2348","DOI":"10.1182\/blood-2009-11-255976","article-title":"RUNX1 Mutations Are Frequent in de Novo AML with Noncomplex Karyotype and Confer an Unfavorable Prognosis","volume":"117","author":"Schnittger","year":"2011","journal-title":"Blood"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1345","DOI":"10.1182\/blood.2022016867","article-title":"Diagnosis and Management of AML in Adults: 2022 Recommendations from an International Expert Panel on Behalf of the ELN","volume":"140","author":"Wei","year":"2022","journal-title":"Blood"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3109","DOI":"10.1200\/JCO.2011.40.6652","article-title":"RUNX1 Mutations Are Associated With Poor Outcome in Younger and Older Patients With Cytogenetically Normal Acute Myeloid Leukemia and With Distinct Gene and MicroRNA Expression Signatures","volume":"30","author":"Mendler","year":"2012","journal-title":"J. Clin. 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