Gene mutation patterns in patients with minimally differentiated acute myeloid leukemia.

Gene mutation patterns in patients with minimally differentiated acute myeloid leukemia.
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DOI:
10.1016/j.neo.2014.06.002
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发表时间:
2014-06
期刊:
影响因子:
4.8
通讯作者:
Shih, Lee-Yung
Shih, Lee-Yung
中科院分区:
医学2区
文献类型:
--
作者:
Kao, Hsiao-Wen;Liang, Der-Cherng;Wu, Jin-Hou;Kuo, Ming-Chung;Wang, Po-Nan;Yang, Chao-Ping;Shih, Yu-Shu;Lin, Tung-Huei;Huang, Yu-Hui;Shih, Lee-Yung

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急性髓细胞白血病(AML)是一种罕见的急性髓细胞白血病亚型,预后差。尽管AML中的基因改变报道越来越多,但在AML-M0中尚未对基因突变进行全面研究。我们的目的是检查AML-M0患者的广泛基因突变,以确定其临床相关性。在67例AML-M0患者中分析了20种基因突变,包括表观遗传调节因子的I类、II类、III类(IDH 1、IDH 2、TET 2、DNMT 3A、MLL-PTD、ASXL 1和EZH 2)和IV类(肿瘤抑制基因)。采用基于聚合酶链反应的测定法进行突变分析,然后进行直接测序。我们数据中最常见的基因突变是FLT 3-ITD/FLT 3-TKD(28.4%),其次是IDH 1/IDH 2(28.8%)、RUNX 1(23.9%)、N-RAS/K-RAS(12.3%)、TET 2(8.2%)、DNMT 3A(8.1%)、MLL-PTD(7.8%)和ASXL 1(6.3%)突变。79%(53/67)的患者至少有一个基因突变。I类基因(49.3%)是最常见的突变基因,它们是互斥的。表观遗传调节因子III类基因也很常见(43.9%)。在多变量分析中,高龄[风险比(HR)1.029,95%置信区间(CI)1.013-1.044,P = .001)是总生存期的独立不利因素,RUNX 1突变(HR 2.326,95% CI 0.978-5.533,P = .056)有生存期较差的趋势。总之,我们的研究表明,在AML-M0中FLT 3、RUNX 1和IDH突变的频率很高,这表明这些突变在发病机制中起作用,并在这种罕见且不利的AML亚型中作为潜在的治疗靶点。
Minimally differentiated acute myeloid leukemia (AML-M0) is a rare subtype of AML with poor prognosis. Although genetic alterations are increasingly reported in AML, the gene mutations have not been comprehensively studied in AML-M0. We aimed to examine a wide spectrum of gene mutations in patients with AML-M0 to determine their clinical relevance. Twenty gene mutations including class I, class II, class III of epigenetic regulators (IDH1, IDH2, TET2, DNMT3A, MLL-PTD, ASXL1, and EZH2), and class IV (tumor suppressor genes) were analyzed in 67 patients with AML-M0. Mutational analysis was performed with polymerase chain reaction–based assays followed by direct sequencing. The most frequent gene mutations from our data were FLT3-ITD/FLT3-TKD (28.4%), followed by mutations in IDH1/IDH2 (28.8%), RUNX1 (23.9%), N-RAS/K-RAS (12.3%), TET2 (8.2%), DNMT3A (8.1%), MLL-PTD (7.8%), and ASXL1 (6.3%). Seventy-nine percent (53/67) of patients had at least one gene mutation. Class I genes (49.3%) were the most common mutated genes, which were mutually exclusive. Class III genes of epigenetic regulators were also frequent (43.9%). In multivariate analysis, old age [hazard ratio (HR) 1.029, 95% confidence interval (CI) 1.013-1.044, P = .001) was the independent adverse factor for overall survival, and RUNX1 mutation (HR 2.326, 95% CI 0.978-5.533, P = .056) had a trend toward inferior survival. In conclusion, our study showed a high frequency of FLT3, RUNX1, and IDH mutations in AML-M0, suggesting that these mutations played a role in the pathogenesis and served as potential therapeutic targets in this rare and unfavorable subtype of AML.
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发表时间: 2005-01-20
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发表时间: 2010-12-16
期刊: The New England journal of medicine
影响因子: --
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Ley TJ;Ding L;Walter MJ;McLellan MD;Lamprecht T;Larson DE;Kandoth C;Payton JE;Baty J;Welch J;Harris CC;Lichti CF;Townsend RR;Fulton RS;Dooling DJ;Koboldt DC;Schmidt H;Zhang Q;Osborne JR;Lin L;O'Laughlin M;McMichael JF;Delehaunty KD;McGrath SD;Fulton LA;Magrini VJ;Vickery TL;Hundal J;Cook LL;Conyers JJ;Swift GW;Reed JP;Alldredge PA;Wylie T;Walker J;Kalicki J;Watson MA;Heath S;Shannon WD;Varghese N;Nagarajan R;Westervelt P;Tomasson MH;Link DC;Graubert TA;DiPersio JF;Mardis ER;Wilson RK
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