Chen Meiyu, Liu Jie, Chao Hongying, Qin Wei, Jiang Naike, Lu Xuzhang, Cen Ling, Jiang Yu, Cai Xiaohui, Zhang Ri, Wang Qian
Department of Hematology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, Jiangsu 213000, China.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi. 2020 Feb 10;37(2):110-115. doi: 10.3760/cma.j.issn.1003-9406.2020.02.003.
To detect ASXL1 gene variants among patients with myelodysplastic syndrome (MDS) and explore their correlation with variants of other genes and clinical features of patients.
For 149 patients with MDS, genomic DNA was amplified by PCR and subject to direct sequencing to identify variants of ASXL1, U2AF1, SF3B1, DNMT3A, TET2, IDH1/2, NPM1, FLT3-ITD and C-KIT genes.
ASXL1 variants were found among 37 patients (24.8%). Other commonly mutated genes included U2AF1 (22.8%), TET2 (11.4%), DNMT3A (9.4%), NPM1 (8.1%) and SF3B1 (6.0%). The frequency of concurrent U2AF1 and TET2 variants among patients with ASXL1 variants was slightly higher than that of wild-type patients. No significant difference was found in median age, MDS subtype, karyotype, peripheral leukocytes, hemoglobin, platelet levels, and bone marrow blast counts between the ASXL1-variant and the wild-type groups (P> 0.05). Twenty-nine patients harboring ASXL1 variants were followed up, 37.9% progressed to acute myeloid leukemia (AML). The rate of transformation in ASXL1-variant group was significantly higher than the wild-type group (37.9% vs. 14.1%, P< 0.01).
ASXL1 showed a high frequency of variant among MDS patients, which was frequently accompanied with U2AF1 and TET2 variants. Compared with the wild type group, patients with ASXL1 variants were more likely to progress to AML.
检测骨髓增生异常综合征(MDS)患者中ASXL1基因变异情况,并探讨其与其他基因变异及患者临床特征的相关性。
对149例MDS患者,采用聚合酶链反应(PCR)扩增基因组DNA,直接测序鉴定ASXL1、U2AF1、SF3B1、DNMT3A、TET2、IDH1/2、NPM1、FLT3-ITD和C-KIT基因变异。
37例患者(24.8%)检测到ASXL1变异。其他常见突变基因包括U2AF1(22.8%)、TET2(11.4%)、DNMT3A(9.4%)、NPM1(8.1%)和SF3B1(6.0%)。ASXL1变异患者中U2AF1和TET2变异同时存在的频率略高于野生型患者。ASXL1变异组与野生型组在中位年龄、MDS亚型、核型、外周血白细胞、血红蛋白、血小板水平及骨髓原始细胞计数方面差异无统计学意义(P>0.05)。对29例携带ASXL1变异的患者进行随访,37.9%进展为急性髓系白血病(AML)。ASXL1变异组的转化率显著高于野生型组(37.9%对14.1%,P<0.01)。
ASXL1在MDS患者中变异频率较高,常伴有U2AF1和TET2变异。与野生型组相比,ASXL1变异患者更易进展为AML。