Kong Jun, Zhao Xiao-Su, Qin Ya-Zhen, Zhu Hong-Hu, Jia Jin-Song, Jiang Qian, Wang Jing, Zhao Ting, Huang Xiao-Jun, Jiang Hao
a Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation , Peking University People's Hospital, Institute of Hematology , Beijing , People's Republic of China.
Leuk Lymphoma. 2018 Apr;59(4):967-972. doi: 10.1080/10428194.2017.1352091. Epub 2017 Jul 26.
This study aimed to analyze the effects of the initial MLL-partial tandem duplication (PTD) expression levels on clinical outcomes in 36 MLL-PTD-positive acute myeloid leukemia (AML) patients between 2014 and 2016. ROC curves showed 1.0% MLL-PTD as the optimal diagnostic cutoff for complete remission (CR). Nineteen and 17 cases had MLL-PTD <1.0% (low-level group) and ≥1.0% (high-level group), respectively. The FAB type distribution (M2 incidence, 100% vs. 53%, p = .003) and double-CEBPA-mutation incidence (37% vs. 0%, p = .008) significantly differed between the groups, as did the CR rates after the first (78.9% vs. 35.3%, p = .008) and second chemotherapies (84.2% vs. 47.1%, p = .001). High MLL-PTD level was the only independent factor affecting the CR rate (odds ratio = 0.16, p = .024). The 24-month overall survival was significantly lower in the high-level group (52.6% vs. 29.4%, p = .043). In conclusion, AML patients with high initial MLL-PTD levels have lower induction CR and survival rates.
本研究旨在分析2014年至2016年间36例MLL部分串联重复（PTD）阳性急性髓系白血病（AML）患者初始MLL-PTD表达水平对临床结局的影响。ROC曲线显示，MLL-PTD为1.0%是完全缓解（CR）的最佳诊断临界值。19例和17例患者的MLL-PTD分别<1.0%（低水平组）和≥1.0%（高水平组）。两组间FAB分型分布（M2发生率，100%对53%，p = 0.003）和双CEBPA突变发生率（37%对0%，p = 0.008）有显著差异，首次化疗（78.9%对35.3%，p = 0.008）和第二次化疗后的CR率（84.2%对47.1%，p = 0.001）也有显著差异。高MLL-PTD水平是影响CR率的唯一独立因素（优势比=0.16，p = 0.024）。高水平组的24个月总生存率显著较低（52.6%对29.4%，p = 0.043）。总之，初始MLL-PTD水平高的AML患者诱导CR率和生存率较低。
