Predictive value of high EVI1 expression in AML patients undergoing myeloablative allogeneic hematopoietic stem cell transplantation in first CR
Predictive value of high EVI1 expression in AML patients undergoing myeloablative allogeneic hematopoietic stem cell transplantation in first CR
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EVI1高表达对首次CR清髓性异基因造血干细胞移植的AML患者的预测价值
DOI：
10.1038/bmt.2016.71
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发表时间：
2016-07-01
影响因子：
4.8
通讯作者：
Wu, D.
中科院分区：
文献类型：
--
作者：
He, X.;Wang, Q.;Wu, D.
EVI1基因是造血干细胞自我更新的转录调节因子，其过表达与新发AML的不良预后相关。EVI1的过表达是否也预示着首次CR （CR1）中接受清髓异基因造血干细胞移植（alloo - hsct）的AML患者预后不良尚不清楚。151例患者中32例（21.2%）属于EVI1高表达（EVI1+）， 119例（78.8%）属于EVI1低表达（EVI1−）。不良风险组EVI1+发生率明显高于中危组（53% vs 19%， P= 0.005）。EVI1+患者极有可能在11q23上发生涉及MLL基因的易位（8/9）。EVI1+组在无白血病生存（LFS）（24个月52.6 vs 71.0%， P= 0.027）、总生存（OS）（24个月52.8 vs 72.4%， P= 0.012）和累积复发率（24个月39.5 vs 22.5%， P= 0.013）方面的结果明显较差。多变量分析显示，低EVI1表达是有利于LFS的独立预后因素（风险比= 0.47,95%可信区间0.26-0.86，P= 0.01），而非OS。我们的研究结果表明，高EVI1表达可能预示着在CR1中接受清髓性同种异体造血干细胞移植的AML患者复发的高风险。
The EVI1 gene is a transcriptional regulator of hematopoietic stem cell self renewal and its overexpression is associated with adverse prognosis in de novo AML. Whether the overexpression of EVI1 also predicts poor outcome of AML patients undergoing myeloablative allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first CR (CR1) is still unclear. Thirty-two (21.2%) out of 151 patients were categorized as high EVI1 expression (EVI1+), and 119 (78.8%) patients were categorized as low EVI1 expression (EVI1−). The frequency of EVI1+ was much higher in the adverse-risk group than the intermediate-risk group (53% vs 19%, P= 0.005). EVI1+ patients were significantly likely to harbor with translocations involving the MLL gene on 11q23 (8/9). Significantly poor results were observed in the EVI1+ cohort in terms of leukemia-free survival (LFS)(in 24 months 52.6 vs 71.0%, P= 0.027), overall survival (OS)(in 24 months 52.8 vs 72.4%, P= 0.012), and cumulative incidence of relapse (in 24 months 39.5 vs 22.5%, P= 0.013). Multivariable analysis revealed that low EVI1 expression as an independent prognostic factor favoring LFS (hazards ratio= 0.47, 95% confidence interval 0.26–0.86, P= 0.01) but not OS. Our results indicate high EVI1 expression might predict high risk of relapse in AML patients undergoing myeloablative allo-HSCT in CR1.