Association between DNMT3A mutations and prognosis of adults with de novo acute myeloid leukemia: a systematic review and meta-analysis.
Association between DNMT3A mutations and prognosis of adults with de novo acute myeloid leukemia: a systematic review and meta-analysis.
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DNMT3A 突变与成人新发急性髓系白血病预后之间的关联：系统评价和荟萃分析
DOI：
10.1371/journal.pone.0093353
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Huang H
中科院分区：
文献类型：
--
作者：
Tie R;Zhang T;Fu H;Wang L;Wang Y;He Y;Wang B;Zhu N;Fu S;Lai X;Shi J;Huang H
背景 DNA 甲基转移酶 3A (DNMT3A) 突变被认为与成人新发急性髓系白血病 (AML) 的不良预后独立相关，然而，关于这一主题仍存在争议。在此，我们旨在进一步研究DNMT3A突变与AML患者预后之间的关系。方法 从多个数据库中确定符合条件的研究，包括 PubMed、Embase、Web of Science、ClinicalTrials 和 Cochrane 图书馆（截至 2013 年 6 月）。主要终点是总生存期（OS），而无复发生存期（RFS）和无事件生存期（EFS）被选为次要终点。如果可能，我们将分别合并随机效应模型和固定效应模型中结果的估计效应（风险比 [HR] 和 95% 置信区间 [CI]）。结果 纳入了 12 项队列研究，涉及 6377 名患者，探讨 DNMT3A 突变对预后的潜在意义。与野生型携带者相比，DNMT3A 突变患者的 OS 稍短（HR = 1.60；95% CI，1.31–1.95；P<0.001）。在年龄小于 60 岁的患者中，DNMT3A 突变预测 OS 较差（HR = 1.84；95% CI，1.36–2.50；P<0.001）。此外，突变型 DNMT3A 预测基因型异常异常的患者的 OS 较差（HR = 2.30；95% CI，1.78–2.97；P = 0.862）。在其他一些亚组中也发现了类似的结果。然而，在有利基因型亚组中，OS 没有发现显着的预后价值（HR = 1.40；95% CI，0.98–1.99；P = 0.798）。在不同条件下的 RFS 和 EFS 上也发现了相似的结果。结论 DNMT3A 突变对总人群和某些特定亚组中新发 AML 成人患者的 OS、RFS 和 EFS 有轻微但显着的不良预后影响。
Background DNA methyltransferase 3A (DNMT3A) mutations were considered to be independently associated with unfavorable prognosis in adults with de novo acute myeloid leukemia (AML), however, there are still debates on this topic. Here, we aim to further investigate the association between DNMT3A mutations and prognosis of patients with AML. Methods Eligible studies were identified from several data bases including PubMed, Embase, Web of Science, ClinicalTrials and the Cochrane Library (up to June 2013). The primary endpoint was overall survival (OS), while relapse-free survival (RFS) and event-free survival (EFS) were chosen as secondary endpoints. If possible, we would pool estimate effects (hazard ratio [HR] with 95% confidence interval[CI]) of outcomes in random and fixed effects models respectively. Results That twelve cohort studies with 6377 patients exploring the potential significance of DNMT3A mutations on prognosis were included. Patients with DNMT3A mutations had slightly shorter OS (HR = 1.60; 95% CI, 1.31–1.95; P<0.001), as compared to wild-type carriers. Among the patients younger than 60 years of age, DNMT3A mutations predicted a worse OS (HR = 1.84; 95% CI, 1.36–2.50; P<0.001). In addition, mutant DNMT3A predicted inferior OS (HR = 2.30; 95% CI, 1.78–2.97; P = 0.862) in patients with unfavorable genotype abnormalities. Similar results were also found in some other subgroups. However, no significant prognostic value was found on OS (HR = 1.40; 95% CI, 0.98–1.99; P = 0.798) in the favorable genotype subgroup. Similar results were found on RFS and EFS under different conditions. Conclusions DNMT3A mutations have slightly but significantly poor prognostic impact on OS, RFS and EFS of adults with de novo AML in total population and some specific subgroups.
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影响因子：
158.5
作者：
Falini, B;Mecucci, C;Martelli, MF
通讯作者：
Martelli, MF
影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
4.8
作者：
Palmer, Tom M.;Peters, Jaime L.;Moreno, Santiago G.
通讯作者：
Moreno, Santiago G.
DOI：
10.1056/nejmoa1005143
发表时间：
2010-12-16
期刊：
The New England journal of medicine
影响因子：
--
作者：
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
通讯作者：
Wilson RK
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N