Picharski Gledson L, Andrade Diancarlos P, Fabro Ana Luiza M R, Lenzi Luana, Tonin Fernanda S, Ribeiro Raul C, Figueiredo Bonald C
Instituto de Pesquisa Pelé Pequeno Príncipe, 1532 Silva Jardim, AV., Curitiba, Paraná 80250-200, Brazil.
Faculdades Pequeno Príncipe, 333 Iguaçu Av., Rebouças, Curitiba, Paraná 80230-902, Brazil.
Cancers (Basel). 2019 Sep 5;11(9):1311. doi: 10.3390/cancers11091311.
The association of mutations with white blood cell (WBC) counts at diagnosis and early death was studied in patients with acute promyelocytic leukemia (APL). Publications indexed in databases of biomedical literature were analyzed. Potential publication bias was evaluated by analyzing the standard error in funnel plots using the estimated relative risk (RR). Mixed-effect models were used to obtain the consolidated RR. All analyses were conducted using the R statistical software package. We used 24 publications in the final meta-analysis. Of 1005 males and 1376 females included in these 24 publications, 645 had -ITD (internal tandem duplication) mutations. Information on -D835 mutations was available in 10 publications for 175 patients. Concurrent occurrence of the two mutations was rare. WBC count at diagnosis was ≥10 × 10/L in 351 patients. For patients with the -ITD mutation, RR was 0.59 for overall survival (OS) and 1.62 for death during induction. For those with -D835 mutations, the RR was 0.50 for OS and 1.77 for death during induction. RR for WBC count ≥10 × 10/L was 3.29 and 1.48 for patients with -ITD and -D835, respectively. APL patients with -ITD or -D835 are more likely to present with elevated WBC counts and poorer prognosis than those without these mutations.
在急性早幼粒细胞白血病（APL）患者中，研究了突变与诊断时白细胞（WBC）计数及早期死亡之间的关联。对生物医学文献数据库中索引的出版物进行了分析。通过使用估计的相对风险（RR）分析漏斗图中的标准误差来评估潜在的发表偏倚。采用混合效应模型获得合并RR。所有分析均使用R统计软件包进行。最终的荟萃分析中我们使用了24篇出版物。在这24篇出版物纳入的1005名男性和1376名女性中，645人有内部串联重复（-ITD）突变。在10篇出版物中有175名患者的-D835突变信息。两种突变同时出现的情况很少见。351名患者诊断时的白细胞计数≥10×10⁹/L。对于有-ITD突变的患者，总生存期（OS）的RR为0.59，诱导期死亡的RR为1.62。对于有-D835突变的患者，OS的RR为0.50，诱导期死亡的RR为1.77。有-ITD和-D835突变的APL患者比没有这些突变的患者更有可能出现白细胞计数升高且预后较差。
