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中国急性髓系白血病患者 IDH1 突变的频率及临床意义。

The Frequency and clinical significance of IDH1 mutations in Chinese acute myeloid leukemia patients.

机构信息

Department of Hematology and Hainan Branch, General Hospital of PLA, Beijing, China.

Department of Hematology, China-Japan Friendship Hospital, Beijing, China.

出版信息

PLoS One. 2013 Dec 20;8(12):e83334. doi: 10.1371/journal.pone.0083334. eCollection 2013.

Abstract

OBJECTIVE

Mutations in the gene encoding isocitrate dehydrogenease 1 (IDH1) occur in various hematopoietic tumors including acute myeloid leukemia (AML), myeloproliferative neoplasms and myelodysplastic syndromes. IDH1 mutations are significant in both diagnosis and prognosis of these conditions. In the present study we determined the prevalence and clinical significance of IDH1 mutations in 349 samples from newly diagnosed AML patients.

RESULTS

Of the 349 AML patient specimens analyzed, 35 (10.03%) were found to have IDH1 mutations including 4 IDH1 R132 mutations and 31 non-R132 mutations. IDH1 non-R132 mutations were largely concentrated within AML-M1 (35.72%, p<0.01). We identified five IDH1 mutations that were novel to AML: (1) c.299 G>A, p.R100Q; (2) c.311G>T, p.G104V; (3) c.322T>C, p.F108L; (4) c.356G>A, p.R119Q; and (5) c.388A>G, p.I130V. In addition, we identified three IDH1 mutations that were previously described in AML. The frequency of IDH1 mutations in AML patients with normal karyotype was 9.9%. IDH1 non-R132 mutations were concurrent with mutations in FLT3-ITD (p<0.01), CEBPA (p<0.01), and NRAS (p<0.01), as well as the overexpression of MN1 (p<0.01) and WT1(p<0.01). The overall survival (OS) in the patients with IDH1 non-R132 mutations compared to patients without IDH1 mutations don't reach statistically significance (median 521 days vs median: not reached; n.s.).

CONCLUSION

IDH1 non-R132 mutations occurred frequently in newly diagnosed adult Chinese AML patients, and these mutations were associated with genetic alterations. The OS was not influenced by IDH1 non-R132 mutations in the present study.

摘要

目的

异柠檬酸脱氢酶 1(IDH1)基因编码的突变发生在各种造血肿瘤中,包括急性髓系白血病(AML)、骨髓增生性肿瘤和骨髓增生异常综合征。IDH1 突变在这些疾病的诊断和预后中都具有重要意义。在本研究中,我们确定了 349 例新诊断的 AML 患者样本中 IDH1 突变的患病率和临床意义。

结果

在分析的 349 例 AML 患者标本中,发现 35 例(10.03%)存在 IDH1 突变,包括 4 例 IDH1 R132 突变和 31 例非-R132 突变。IDH1 非-R132 突变主要集中在 AML-M1(35.72%,p<0.01)。我们鉴定了 5 种 AML 中的新型 IDH1 突变:(1)c.299 G>A,p.R100Q;(2)c.311G>T,p.G104V;(3)c.322T>C,p.F108L;(4)c.356G>A,p.R119Q;(5)c.388A>G,p.I130V。此外,我们还鉴定了 3 种以前在 AML 中描述过的 IDH1 突变。核型正常的 AML 患者中 IDH1 突变的频率为 9.9%。IDH1 非-R132 突变与 FLT3-ITD(p<0.01)、CEBPA(p<0.01)和 NRAS(p<0.01)的突变以及 MN1(p<0.01)和 WT1(p<0.01)的过度表达同时发生。与无 IDH1 突变的患者相比,存在 IDH1 非-R132 突变的患者的总生存(OS)无显著差异(中位 521 天 vs 未达到;n.s.)。

结论

IDH1 非-R132 突变在新诊断的中国成年 AML 患者中频繁发生,这些突变与基因改变相关。在本研究中,IDH1 非-R132 突变对 OS 没有影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7055/3869765/f177c577d6c3/pone.0083334.g001.jpg

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