Prognostic value of genetic mutations in adolescent and young adults with acute myeloid leukemia
Prognostic value of genetic mutations in adolescent and young adults with acute myeloid leukemia
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基因突变对青少年和年轻人急性髓系白血病的预后价值
DOI：
10.1007/s12185-017-2340-z
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发表时间：
2017
影响因子：
2.1
通讯作者：
Kiyoi H et al.
中科院分区：
文献类型：
--
作者：
Kuwatsuka Y;Asou N;Ohtake S;Miyawaki S;Miyazaki Y;Sakura T;Ozawa Y;Usui N;Kanamori H;Ito Y;Imai K;Suehiro Y;Kobayashi S;Kitamura K;Sakaida E;Ogawa S;Naoe T;Hayashi Y;Horibe K;Manabe A;Mizutani S;Adachi S;Kiyoi H et al.
已知青少年和年轻人（AYAs）急性髓性白血病（AML）的临床结局和遗传背景在年幼儿童和老年人中存在差异。为了阐明基因突变对AML患者临床结局的影响，我们分析了JPLSG AML-05和JALSG AML 201研究的数据。分析103例年龄在15-39岁的AYA患者的FLT 3-ITD、KIT、CEBPA、NRAS、KRAS、WT 1、MLL-PTD和NPM 1基因突变情况。在多变量分析中，FLT 3-ITD（HR 2.10; 95%CI 1.07-4.12;p= 0.031）和NPM 1（HR 0.24; 95%CI 0.06-1.00;p= 0.050）突变与总死亡率风险相关。根据FLT 3-ITD和NPM 1突变状态，OS显著不同（p= 0.03）。NPM 1突变组在无FLT 3-ITD的情况下生存率为100%，FLT 3-ITD组在无NPM 1突变的情况下生存率为35%（95%CI 14-57%）。AML-05和AML 201参与者中的AYA、儿童（n= 413）和老年人（n= 124）的OS存在显著差异（p< 0.0001）。这是第一份联合收割机结合日本主要儿童和成人研究组AYA AML的临床和遗传数据的报告。
Clinical outcomes and the genetic background of acute myeloid leukemia (AML) in adolescent and young adults (AYAs) are known to differ in younger children and older adults. To clarify the impact of genetic mutations on clinical outcomes of AYAs with AML, we analyzed data from the JPLSG AML-05 and JALSG AML201 studies. AYAs aged 15–39 years (n= 103) were included.FLT3-ITD,KIT,CEBPA,NRAS,KRAS,WT1,MLL-PTD, andNPM1mutations were analyzed. Overall survival (OS) of the AYAs was 61% and event-free survival was 38% at 3 years.FLT3-ITD (HR 2.10; 95% CI 1.07–4.12;p= 0.031) andNPM1(HR 0.24; 95% CI 0.06–1.00;p= 0.050) mutations were associated with risk of overall mortality in multivariate analysis. OS was significantly different according toFLT3-ITD andNPM1mutation status (p= 0.03). Survival was 100% withNPM1mutations in the absence ofFLT3-ITD and 35% (95% CI 14–57%) withFLT3-ITD in the absence ofNPM1mutations. The OS of AYAs, children (n= 413) and older adults (n= 124) of the AML-05 and AML201 participants were significantly different (p< 0.0001). This is the first report to combine clinical and genetic data of AYA AML from the major Japanese pediatric and adult study groups.