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正常核型急性髓系白血病中的拷贝数变异及其与治疗反应的关系。

Copy number variations in normal karyotype acute myeloid leukaemia and their association with treatment response.

机构信息

College of Pharmacy, Seoul National University, Seoul, Korea.

出版信息

Basic Clin Pharmacol Toxicol. 2012 Nov;111(5):317-24. doi: 10.1111/j.1742-7843.2012.00904.x. Epub 2012 Jun 29.

Abstract

Copy number variation (CNV) has been reported to be associated with chemotherapy response, which affects disease prognosis. Here, we determined the frequency of genome-wide cytogenetic CNV aberrations in Korean patients with normal karyotype (NK) acute myeloid leukaemia (AML) and tested whether these genomic variations contribute to differences in Ara-C and anthracycline-based chemotherapy responses. Bone marrow aspirates and blood from 30 previously untreated de novo NK-AML patients were provided at the time of diagnosis for copy number analysis. Possible associations between cytogenetic aberrations and clinical parameters were analysed. CNVs were identified in 23 (76.7%) of the 30 cases tested. Multivariate analyses controlled for other clinical co-variates showed that patients having copy number loss had a decreased probability of complete remission (OR, 0.015 [95% CI, 0-0.737], p = 0.035). Patients who had a copy number gain of more than four regions tended to have shorter event-free survival (EFS) (p = 0.083) with multivariate analysis showing that CNV increase is an independent predictive factor for shorter EFS (HR, 22.104 [95% CI, 1.644-297.157], p = 0.020). In addition, we identified candidate genes that may be involved in Ara-C and anthracycline drug response in Korean patients with NK-AML. These results suggest that CNVs may affect the success of Ara-C and anthracycline-based chemotherapy in Korean patients with NK-AML.

摘要

拷贝数变异 (CNV) 已被报道与化疗反应相关,从而影响疾病预后。在这里,我们确定了具有正常核型 (NK) 的韩国急性髓系白血病 (AML) 患者全基因组细胞遗传学 CNV 异常的频率,并检测了这些基因组变异是否导致阿糖胞苷和蒽环类药物为基础的化疗反应的差异。在诊断时,从 30 名未经治疗的初治 NK-AML 患者中提供骨髓抽吸物和血液,用于拷贝数分析。分析了细胞遗传学异常与临床参数之间的可能关联。在 30 例检测的病例中,有 23 例 (76.7%) 存在 CNV。多变量分析控制了其他临床协变量,结果显示,存在拷贝数缺失的患者完全缓解的概率降低(OR,0.015 [95%CI,0-0.737],p=0.035)。拷贝数增加超过四个区域的患者无事件生存(EFS)较短(p=0.083),多变量分析显示 CNV 增加是 EFS 较短的独立预测因子(HR,22.104 [95%CI,1.644-297.157],p=0.020)。此外,我们鉴定了可能参与 NK-AML 韩国患者阿糖胞苷和蒽环类药物药物反应的候选基因。这些结果表明,CNV 可能影响韩国 NK-AML 患者阿糖胞苷和蒽环类药物为基础的化疗的成功率。

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