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骨髓增生异常综合征患者的突变谱分析:准备好用于临床日常实践了吗?

Mutational profiling in patients with MDS: ready for every-day use in the clinic?

作者信息

Bacher Ulrike, Kohlmann Alexander, Haferlach Torsten

机构信息

MLL Munich Leukemia Laboratory, Munich, Germany.

MLL Munich Leukemia Laboratory, Munich, Germany.

出版信息

Best Pract Res Clin Haematol. 2015 Mar;28(1):32-42. doi: 10.1016/j.beha.2014.11.005. Epub 2014 Nov 12.

Abstract

Multiple recurrent somatic mutations were identified in the majority of patients with myelodysplastic syndromes (MDS), but investigating the broad spectrum of molecular markers in MDS exceeds many laboratories' capacity when traditional molecular techniques are used. High-throughput second generation sequencing (=next-generation sequencing, NGS) has proven to be applicable for comprehensive biomarker mutation analyses allowing to increase diagnostic sensitivity and accuracy and to improve risk stratification and prognostication in addition to cytomorphology and cytogenetic analysis in patients with MDS. Amplicon deep-sequencing enables comprehensive biomarker analysis in a multitude of patients per investigation in an acceptable turn-around time and at affordable costs. Comprehensive myeloid marker panels were successfully introduced into diagnostic practice. Therefore, molecular mutation analysis is ready for use in all patients with suspected MDS, may contribute to risk stratification in possible candidates for allogeneic stem cell transplantation, and should become an integral part of clinical research studies in MDS patients.

摘要

在大多数骨髓增生异常综合征(MDS)患者中都发现了多个复发性体细胞突变,但使用传统分子技术研究MDS中的广泛分子标志物超出了许多实验室的能力。高通量第二代测序(=下一代测序,NGS)已被证明适用于全面的生物标志物突变分析,除了MDS患者的细胞形态学和细胞遗传学分析外,还能提高诊断敏感性和准确性,并改善风险分层和预后。扩增子深度测序能够在可接受的周转时间内以可承受的成本对大量患者进行全面的生物标志物分析。全面的髓系标志物检测板已成功引入诊断实践。因此,分子突变分析已准备好用于所有疑似MDS患者,可能有助于对异基因干细胞移植的潜在候选者进行风险分层,并且应该成为MDS患者临床研究的一个组成部分。

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