Department of Hematology and Blood Banking, School of Allied Medicine, Iran University of Medical Sciences, Tehran, Iran.
Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, IBTO HQ, Tehran, Iran.
Leuk Res. 2021 Feb;101:106512. doi: 10.1016/j.leukres.2021.106512. Epub 2021 Jan 19.
Chronic Myeloid Leukemia (CML) is characterized by the overproduction of BCR-ABL, a tyrosine kinase with constitutive activity, in which the majority of CML patients have e13a2 or e14a2 transcripts. Reckoned the possible associations between the hematologic and molecular features of the disease, a profound understanding of different aspects of this neoplasm would be provided.
The authors implemented a systematic literature search, utilizing the terms published articles or internationally accepted abstracts from PubMed, Embase, Medline, Cochrane library before January 2019. Weighted mean proportion and 95 % confidence intervals (CIs) of CML prevalence calculated using a fixed-effects and a random-effects model. Statistical heterogeneity was evaluated using the I2 statistic.
34 studies for a total of 54,034 Patients were selected and included in the review. Results revealed that compared to e13a2 group, the overall estimated prevalence is much higher in the e14a2 (39 % and 54 %, respectively). Besides, the overall estimated prevalence ratio of male to female was higher in the e13a2 group in comparison to e14a2 (1.08 and 0.856 respectively). The overall estimated prevalence of dual transcription of e13a2/e14a2 was 1.11 %, and male/female overall estimated prevalence ratio was 1.18.
This meta-analysis of CML patients demonstrated the e14a2 as the more common transcript type. Usually, the e14a2 transcript is prevalent in females, whereas e13a2 and dual transcription of e13a2/e14a2 are more common in men. These data explicate that the differences in proportion are not by chance. This is crucial, as the transcript type is a variable suspected to be of prognostic importance for the treatment-related response, the outcome of treatment, and the rate of treatment-free remission.
慢性髓性白血病（CML）的特征是产生过多的 BCR-ABL，这是一种具有组成性活性的酪氨酸激酶，其中大多数 CML 患者具有 e13a2 或 e14a2 转录本。为了了解疾病的血液学和分子特征之间的可能关联，深入了解这种肿瘤的不同方面将提供帮助。
作者进行了系统的文献检索，使用了在 2019 年 1 月之前在 PubMed、Embase、Medline 和 Cochrane 图书馆发表的文章或国际公认的摘要的术语。使用固定效应和随机效应模型计算 CML 患病率的加权平均比例和 95%置信区间（CI）。使用 I2 统计量评估统计异质性。
选择了 34 项研究，共纳入了 54034 名患者。结果表明，与 e13a2 组相比，e14a2 组的总体估计患病率要高得多（分别为 39%和 54%）。此外，与 e14a2 组相比，e13a2 组中男性与女性的总体估计患病率比更高（分别为 1.08 和 0.856）。e13a2/e14a2 双重转录的总体估计患病率为 1.11%，男性/女性的总体估计患病率比为 1.18。
这项对 CML 患者的荟萃分析表明，e14a2 是更常见的转录本类型。通常，e14a2 转录本在女性中更为常见，而 e13a2 和 e13a2/e14a2 双重转录本在男性中更为常见。这些数据表明，这种比例的差异并非偶然。这很重要，因为转录本类型是一个变量，被怀疑对治疗相关反应、治疗结果和无治疗缓解率具有预后意义。
