高 DNA 甲基转移酶 DNMT3B 水平:急性髓系白血病的预后不良标志物。
High DNA methyltransferase DNMT3B levels: a poor prognostic marker in acute myeloid leukemia.
机构信息
Service d'Hématologie Biologique, Centre Hospitalier Lyon-Sud, Pierre-Bénite France, Hospices Civils de Lyon, Lyon, France.
出版信息
PLoS One. 2012;7(12):e51527. doi: 10.1371/journal.pone.0051527. Epub 2012 Dec 10.
It has been recently shown that DNA methyl transferase overexpression is correlated with unfavourable prognosis in human malignancies while methylation deregulation remains a hallmark that defines acute myeloid leukemia (AML). The oncogenic transcription factor EVI1 is involved in methylation deregulation and its overexpression plays a major role for predicting an adverse outcome. Moreover, the identification of DNMT3A mutations in AML patients has recently been described as a poor prognostic indicator. In order to clarify relationship between these key actors in methylation mechanisms and their potential impact on patient outcomes, we analysed 195 de novo AML patients for the expression of DNMT3A, 3B (and its non-catalytic variant 3B(NC)) and their correlations with the outcome and the expression of other common prognostic genetic biomarkers (EVI1, NPM1, FLT3ITD/TKD and MLL) in adult AML. The overexpression of DNMT3B/3B(NC) is (i) significantly correlated with a shorter overall survival, and (ii) inversely significantly correlated with event-free survival and DNMT3A expression level. Moreover, multivariate analysis showed that a high expression level of DNMT3B/3B(NC) is statistically a significant independent poor prognostic indicator. This study represents the first report showing that the overexpression of DNMT3B/3B(NC) is an independent predictor of poor survival in AML. Its quantification should be implemented to the genetic profile used to stratify patients for therapeutical strategies and should be useful to identify patients who may benefit from therapy based on demethylating agents.
最近的研究表明,DNA 甲基转移酶的过度表达与人类恶性肿瘤的不良预后相关,而甲基化失调仍然是定义急性髓细胞白血病(AML)的标志。致癌转录因子 EVI1 参与甲基化失调,其过度表达对预测不良预后起着重要作用。此外,最近在 AML 患者中发现 DNMT3A 突变被描述为预后不良的指标。为了阐明甲基化机制中的这些关键因素与其对患者结局的潜在影响之间的关系,我们分析了 195 例初诊 AML 患者的 DNMT3A、3B(及其非催化变异体 3B(NC))的表达情况,并分析其与其他常见预后遗传生物标志物(EVI1、NPM1、FLT3ITD/TKD 和 MLL)的表达与成人 AML 患者结局的相关性。DNMT3B/3B(NC)的过度表达(i)与总生存期较短显著相关,(ii)与无事件生存期和 DNMT3A 表达水平呈负相关。此外,多变量分析显示,DNMT3B/3B(NC)高表达是统计学上独立的不良预后指标。本研究首次表明,DNMT3B/3B(NC)的过度表达是 AML 患者不良生存的独立预测因子。应该将其定量纳入用于分层治疗策略的遗传谱中,并且应该有助于识别可能受益于基于去甲基化剂的治疗的患者。
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