ABCG2 和 CD200 可用于定义 ELN 有利亚组 AML 中复发风险高的患者。

ABCG2 and CD200 define patients at high risk of relapse in ELN favorable subgroup of AML.

机构信息

Division of Hematology and Stem Cell Transplantation, Azienda Sanitaria Universitaria Integrata, Udine, Italy.

出版信息

Eur J Haematol. 2017 Sep;99(3):269-274. doi: 10.1111/ejh.12915. Epub 2017 Jul 20.

DOI:10.1111/ejh.12915

PMID:28618016

Abstract

OBJECTIVE

Overexpression of ABCG2 and CD200 has been independently associated with poor outcome in acute myeloid leukemia (AML). However, no data are available on the role of these two factors in patients with core-binding factor (CBF)-positive or FLT3-negative/NPM1-mutated cytogenetically normal (CN) AML.

METHODS

We analyzed 65 adult AML patients with CBF+ (n=16) or FLT3-/NPM1+ CN (n=49), evaluating clinical and biological factors associated with complete remission attainment, leukemia-free survival (LFS) and overall survival (OS).

RESULTS

ABCG2 was expressed in 36 (55%) cases, and CD200 was positive in 33 (51%) cases, six at high levels. Both ABCG2 and CD200 positivity have a negative impact on relapse risk: 3-year LFS was 51% vs 82% in ABCG2+ cases (RR 3.3), 49% vs 82% in CD200+ patients (RR=4.4), and 25% in CD200- high cases (RR=17.1). ABCG2 and CD200 affected also OS with 3-year OS of 39% in ABCG2+ (compared to 71% in ABCG2-; RR=2.6) and CD200+ (compared to 68% in CD200-; RR=2.5) patients.

CONCLUSIONS

Our data confirm a negative impact of ABCG2 and CD200 overexpression also in AML patients considered at favorable risk according to ELN cytogenetic/molecular classification.

摘要

目的

ABCG2 和 CD200 的过表达已被独立证实与急性髓系白血病（AML）的不良预后相关。然而，目前尚无关于这两个因素在核心结合因子（CBF）阳性或 FLT3-阴性/NPM1 突变核型正常（CN）AML 患者中的作用的数据。

方法

我们分析了 65 例成人 CBF+（n=16）或 FLT3-/NPM1+ CN（n=49）AML 患者，评估了与完全缓解、无白血病生存（LFS）和总生存（OS）相关的临床和生物学因素。

结果

36 例（55%）患者表达 ABCG2，33 例（51%）患者 CD200 阳性，其中 6 例为高表达。ABCG2 和 CD200 阳性均对复发风险有负面影响：ABCG2+患者 3 年 LFS 为 51% vs 82%（RR 3.3），CD200+患者为 49% vs 82%（RR=4.4），CD200-高表达患者为 25%（RR=17.1）。ABCG2 和 CD200 还影响 OS，ABCG2+患者 3 年 OS 为 39%（与 ABCG2-患者的 71%相比；RR=2.6），CD200+患者为 39%（与 CD200-患者的 68%相比；RR=2.5）。