Department of Hematology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, PR China.
Department of Hematology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, PR China.
Clin Chim Acta. 2018 Apr;479:25-37. doi: 10.1016/j.cca.2018.01.006. Epub 2018 Jan 6.
The conventional risk stratification of acute myeloid leukemia (AML), based on cytogenetics, cannot meet the demand for accurate prognostic evaluations. In recent years, gene mutations are found to be potential markers for more accurate risk stratification, but reports on mutation screening of Chinese AML are limited. We aim to display the mutation patterns of Chinese AML patients, reveal the genotype-phenotype correlations and make a comparison with Caucasians patients.
Genome DNA from 78 patients' bone marrow were extracted for targeted gene mutation panel by next-generation sequencing (NGS) technology. Statistics and bioinformatics were used to analyze the correlations between gene mutations and clinical features, as well as the comparison of our results with the Cancer Genome Atlas Research Network (TCGA) public AML dataset.
We found patients with mutations of FLT3 and TET2 had higher bone marrow blasts, peripheral blasts and white blood cell (WBC) count, mutations of SRSF2 were related with age, and mutations of FLT3-ITD, DNMT3A, IDH1, TET2 and SRSF2 were risk factors for overall survival. What's more, we discovered 15 novel mutations and difference of mutational incidence in 6 genes between Chinese and Caucasians AML. Bioinformatic analysis revealed some relationship between gene mutations and expressions as well as drug sensitivities.
We made an investigation on the mutation patterns of Chinese AML patients by NGS technique and revealed correlations between gene mutations and clinical features. Thus we recommend routine testing of suspected genes for better prognostic prediction and individualized treatment.
基于细胞遗传学的急性髓系白血病(AML)传统风险分层方法无法满足准确预后评估的需求。近年来,基因突变被发现是更准确风险分层的潜在标志物,但关于中国 AML 基因突变筛查的报道有限。我们旨在展示中国 AML 患者的突变模式,揭示基因型-表型相关性,并与高加索患者进行比较。
采用下一代测序(NGS)技术,从 78 例患者骨髓中提取基因组 DNA 进行靶向基因突变panel 检测。采用统计学和生物信息学方法分析基因突变与临床特征的相关性,并将我们的结果与癌症基因组图谱研究网络(TCGA)公共 AML 数据集进行比较。
我们发现 FLT3 和 TET2 基因突变的患者骨髓原始细胞比例、外周血原始细胞比例和白细胞计数较高,SRSF2 基因突变与年龄有关,FLT3-ITD、DNMT3A、IDH1、TET2 和 SRSF2 基因突变是总生存期的危险因素。此外,我们还发现了 15 种新的突变,并发现中国和高加索 AML 患者在 6 个基因的突变发生率上存在差异。生物信息学分析揭示了基因突变与基因表达和药物敏感性之间的一些关系。
我们通过 NGS 技术对中国 AML 患者的突变模式进行了调查,并揭示了基因突变与临床特征之间的相关性。因此,我们建议对疑似基因进行常规检测,以更好地进行预后预测和个体化治疗。