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[TP53突变对异基因造血干细胞移植后Ph阴性B淋巴细胞白血病临床结局的影响]

[The effect of TP53 mutations on the clinical outcomes of Ph-negative B-acute lymphoblastic leukemia following allogeneic hematopoietic stem cell transplantation].

作者信息

Cao X Y, Zhang Y, Liu D Y, Zhang J P, Wei Z J, Xiong M, Sun R J, Lu Y, Zhou J R, Zhao Y L, Ma W, Zhang W

机构信息

Department of Bone Marrow Transplantation, Hebei Yanda Lu Daopei Hospital, Langfang 065201, China.

Molecular Medicine Laboratory, Hebei Yanda Lu Daopei Hospital, Lang fang 065201, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2020 Nov 14;41(11):908-914. doi: 10.3760/cma.j.issn.0253-2727.2020.11.005.

Abstract

To evaluate the association of TP53 mutations with the clinical outcomes of Ph-negative B-ALL following allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Total 300 patients with Ph-negative B-ALL who underwent allo-HSCT at the Hebei Yanda Ludaopei Hospital from May 2012 to May 2017 were retrospectively analyzed; their clinical characteristics, TP53 gene mutation type, and association between TP53 mutations and transplantation outcomes, including leukemia-free survival (LFS) , overall survival (OS) , non-relapse mortality (NRM) , relapse, and GVHD, were evaluated. Total 23 patients had TP53 mutations; all the TP53 mutations affected P53'DNA-binding domain. The 5-year-LFS, OS, and RI were 34.8% and 62.3% (=0.001) , 41.9% and 65.1% (=0.020) , and 47.8% and 14.8% (=0.000) , respectively, for TP53 mutations and wild-type TP53 patients. However, there were no significant differences in NRM and GVHD. Multivariate analysis showed that TP53 mutations remained adverse prognostic factors for LFS, OS, and RI after allo-HSCT. Some patients with TP53 mutations can achieve long-term survival with allo-HSCT. TP53 mutations are adverse prognostic factors for Ph-negative B-ALL patients who undergo allo-HSCT.

摘要

评估TP53突变与异基因造血干细胞移植(allo-HSCT)后Ph阴性B淋巴细胞白血病(B-ALL)临床结局的相关性。回顾性分析2012年5月至2017年5月在河北燕达陆道培医院接受allo-HSCT的300例Ph阴性B-ALL患者;评估其临床特征、TP53基因突变类型以及TP53突变与移植结局之间的相关性,包括无白血病生存期(LFS)、总生存期(OS)、非复发死亡率(NRM)、复发和移植物抗宿主病(GVHD)。共有23例患者发生TP53突变;所有TP53突变均影响P53的DNA结合结构域。TP53突变患者和野生型TP53患者的5年LFS、OS和复发率(RI)分别为34.8%和62.3%(P=0.001)、41.9%和65.1%(P=0.020)、47.8%和14.8%(P=0.000)。然而,NRM和GVHD无显著差异。多因素分析显示,TP53突变仍然是allo-HSCT后LFS、OS和RI的不良预后因素。一些TP53突变患者通过allo-HSCT可实现长期生存。TP53突变是接受allo-HSCT的Ph阴性B-ALL患者的不良预后因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f19/7767807/d26b771db2e3/cjh-41-11-908-g001.jpg

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