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一组CD1a和CD8阳性儿童T细胞急性淋巴细胞白血病的临床血液学特征及拷贝数异常

Clinico-Hematological Profile and Copy Number Abnormalities in a Cohort of and Positive Pediatric T-Cell Acute Lymphoblastic Leukemia.

作者信息

Patra Nilamani, Singh Minu, Sharma Pankaj, Trehan Amita, Naseem Shano, Bansal Deepak, Bhatia Prateek

机构信息

Pediatric Hematology Oncology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Indian J Hematol Blood Transfus. 2021 Oct;37(4):555-562. doi: 10.1007/s12288-020-01394-6. Epub 2021 Jan 25.

Abstract

T cell acute lymphoblastic leukaemia (T-ALL) is a genetically heterogeneous and aggressive form of malignancy. Although a number of recurrent fusion genes are reported in T-ALL, their involvement in disease stratification and therapeutic intervention is still controversial. Considering the prognostic value of fusion and tyrosine kinase inhibitor (TKI) based therapeutic potential of , the present study aimed to investigate their frequency and clinical correlation in pediatric T-ALL cases. Our cohort consisted of 48 T-ALL pediatric cases (age ≤ 12 years) with a median age of 6 years and male to female ratio of 20.5:1. The median TLC of the study group was noted to be 220,000/ cu mm with a range from 26,810/cu mm to 785,430/cu mm. By MLPA and RT-PCR analysis we observed that 11/48 cases (23%) showed fusion and 4/48 cases (8.3%) had fusion gene. Both of the fusion genes did not show any significant correlation with any of the clinico-hematological or treatment outcome parameters. However, upon analysis of copy number variations (CNVs) with other clinically relevant genes, we found significant correlation between ( = 0.024) and ( = 0.049) gene deletions with fusion in T-ALL patients. fusion gene did not reveal any association with either CNVs or with survival. Although limited with the small cohort size and follow up, our study supports the similar frequency of these fusions as compared to other Asian and Western studies and also highlights utility of MLPA technique as a good diagnostic modality to screen for both and fusions in a single assay with additional data on secondary copy number changes.

摘要

T细胞急性淋巴细胞白血病(T-ALL)是一种具有基因异质性且侵袭性强的恶性肿瘤。尽管在T-ALL中报道了许多复发性融合基因,但其在疾病分层和治疗干预中的作用仍存在争议。考虑到融合基因的预后价值以及基于酪氨酸激酶抑制剂(TKI)的治疗潜力,本研究旨在调查它们在儿童T-ALL病例中的频率及其临床相关性。我们的队列包括48例儿童T-ALL病例(年龄≤12岁),中位年龄为6岁,男女比例为20.5:1。研究组的中位白细胞计数(TLC)为220,000/立方毫米,范围为26,810/立方毫米至785,430/立方毫米。通过多重连接依赖探针扩增(MLPA)和逆转录聚合酶链反应(RT-PCR)分析,我们观察到11/48例(23%)显示有 融合,4/48例(8.3%)有 融合基因。这两种融合基因与任何临床血液学或治疗结果参数均无显著相关性。然而,在分析与其他临床相关基因的拷贝数变异(CNV)时,我们发现T-ALL患者中 (=0.024)和 (=0.049)基因缺失与 融合之间存在显著相关性。融合基因与CNV或生存率均无关联。尽管本研究受限于队列规模小和随访时间短,但与其他亚洲和西方研究相比,我们的研究支持这些融合的频率相似,并且还强调了MLPA技术作为一种良好的诊断方法的实用性,可在单次检测中筛查 和 融合,并提供关于二级拷贝数变化的额外数据。

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