The mutation of the plant homeodomain finger protein 6 gene (PHF6MUT) in patients with myeloid neoplasms (MNs) is rare and appears to play a role in prognosis, though this is still under debate. We conducted a retrospective analysis of a cohort of 313 patients diagnosed with MNs. We also performed a systematic review (SR) of the literature to evaluate the prognostic role of PHF6 gene status in MNs. We identified 15 patients with PHF6MUT. In the multivariate analysis, PHF6MUT was associated with higher mortality compared to PHF6wild - type (hazard ratio [HR] = 1.02; 95% confidence interval [CI], 1.00-1.05; P = 0.075), with no apparent impact from other co-mutations. In the multilevel logistic model by MN subtype, the presence of PHF6MUT (independent of variant allele frequency > 20%) was shown to have a positive coefficient (adverse prognosis) in acute myeloid leukemia; in the remainder of MNs, the effect was not significant. PHF6MUT had a marginal and significant effect compared to PHF6wild - type cases (HR = 1.02; 95% CI, 1.00-1.05; P = 0.039). There were no significant differences in time to blast transformation or time to next treatment depending on PHF6 gene status. According to the results of most studies published to date (SR), PHF6MUT has a prognostic role in MNs; our results are consistent in terms of clinical outcomes, but these marginal effects should be interpreted with caution in the context of existing prognostic models given the limitations of the small sample size.
Keywords: PHF6; Acute myeloid leukemia; Myelodisplastic syndrome; Myelodysplastic-myeloproliferative diseases; Myeloproliferative disorders.
© 2026. The Author(s).