The role of <i>CBFβ::MYH11</i> fusion gene in acute lysis pneumopathy: A dual impact on risk and prognosis

Acute lysis pneumopathy (ALP) is a rare but fatal complication that can occur during induction chemotherapy for newly diagnosed acute myeloid leukaemia (AML). Currently, there is a paucity of large case reports detailing high-risk and poor prognostic factors associated with its occurrence. To provide evidence-based guidance on ALP, we conducted a retrospective analysis of 608 patients with newly diagnosed AML (non-M3), among whom 20 developed ALP during hydroxycarbamide (hydroxyurea) therapy and/or induction chemotherapy, resulting in an overall incidence rate of 3.3% (20/608) and a mortality rate of 35% (7/20). Multivariable logistic regression revealed that male (odds ratio [OR] 5.852, 95% confidence interval [CI]: 1.006-34.028, p = 0.049), elevated leucocyte counts (OR 1.125, 95% CI: 1.050-1.205, p = 0.001) and CBFβ::MYH11 fusion positivity (OR 13.821, 95% CI: 3.002-63.634, p = 0.001) were independent risk factors for the occurrence of ALP. Notably, CBFβ::MYH11 fusion positivity was associated with improved survival in ALP patients (p = 0.015). This study provides preliminary insights into the risk and prognostic factors of ALP.