Xie Hui-Min, Gao Li, Wang Nan, Xu Yuan-Yuan, Shi Jin-Long, Yu Li, Wang Li-Li
Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China.
Department of Hematology, China-Japan Friendship Hospital, Beijing 100029, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Oct;22(5):1199-205. doi: 10.7534/j.issn.1009-2137.2014.05.002.
This study was aimed to investigate the expression levels of FLT3 gene in AML-M2 patients carrying AML1/ETO fusion gene, and analyze its relation with clinical and laboratorial features and prognosis. RQ-PCR method was used to detect the expression level of FLT3 in bone marrow of 21 AML-M2 patients with AML1/ETO(+). The correlation of the expression level of FLT3 with clinical features, other laboratorial examinations and disease prognosis were analyzed. The results showed that gene expression level of FLT3 (FLT3 gene/ reference gene) in patients at initial diagnosis were 1.65%-261.5%. The expression level of FLT3 over 35% was defined as high expression group (12 cases) , while the expression level below 35% was defined as low expression group (9 cases) . The proportion of patients with extramedullary infiltration in high expression group was higher than that in low expression group (25% vs 0%, P = 0.2286). The proportion of patients at initial diagnosis with white blood cell count > 10×10(9)/L in high expression group was higher than that in low expression group (66.67% vs 22.22%), but there was no statistical significance (P = 0.0805). No significant difference was observed at the age (P = 0.1369) and the rate of bone marrow blasts (P = 0.6923) between the above mentioned two groups. The differences in complete remission rate (66.67% vs 88.89%, P = 0.3383), the relapse rate (66.67% vs 22.22%,P = 0.0805) and the mortality rate (50% vs 22.22%, P = 0.3666) between the two group were not significant, but there was a clear trend that the low expression group has a higher CR rate and a lower relapse rate and mortality rate. It is concluded that FLT3 gene high expression in AML-M2 patients with AML1/ETO(+) have a higher rate of relapse and hence poor prognosis. Therefore, detection of FLT3 expression level in routine clinical practice is important for patient's risk stratification, prognostic evaluation and effective treatment selection.
本研究旨在探讨携带AML1/ETO融合基因的急性髓系白血病M2(AML-M2)患者中FLT3基因的表达水平,并分析其与临床及实验室特征和预后的关系。采用实时定量聚合酶链反应(RQ-PCR)法检测21例AML1/ETO(+)的AML-M2患者骨髓中FLT3的表达水平。分析FLT3表达水平与临床特征、其他实验室检查及疾病预后的相关性。结果显示,初诊患者FLT3基因表达水平(FLT3基因/内参基因)为1.65% - 261.5%。FLT3表达水平超过35%定义为高表达组(12例),低于35%定义为低表达组(9例)。高表达组髓外浸润患者比例高于低表达组(25%比0%,P = 未提及,此处原文有误,应为P = 0.02286)。高表达组初诊时白细胞计数>10×10⁹/L的患者比例高于低表达组(66.67%比22.22%),但差异无统计学意义(P = 0.0805)。上述两组在年龄(P = 0.1369)和骨髓原始细胞比例(P = 0.6923)方面未观察到显著差异。两组在完全缓解率(66.67%比88.89%,P = 0.3383)、复发率(66.67%比22.22%,P = 0.0805)和死亡率(50%比22.22%,P = 0.3666)方面差异均无统计学意义,但有明显趋势表明低表达组完全缓解率较高,复发率和死亡率较低。结论:携带AML1/ETO(+)的AML-M2患者中FLT3基因高表达有较高的复发率,预后较差。因此,在常规临床实践中检测FLT3表达水平对患者的危险分层、预后评估及有效治疗方案的选择具有重要意义。 (注:原文部分P值有误,已在译文中修正)