Yin Hua, Hong Mei, Deng Jun, Yao Lan, Qian Chenjing, Teng Yao, Li Tingting, Wu Qiuling
Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Collaborative Innovation Center of Hematology, Soochow University, Suzhou, China.
Front Oncol. 2022 Feb 24;12:811151. doi: 10.3389/fonc.2022.811151. eCollection 2022.
Adult T-cell acute lymphoblastic leukemia (T-ALL) is a heterogeneous malignant tumor with poor prognosis. However, accurate prognostic stratification factors are still unclear.
Data from 90 adult T-cell acute lymphoblastic leukemia/lymphoma (T-ALL/LBL) patients were collected. The association of gene mutations detected by next-generation sequencing and clinical characteristics with the outcomes of T-ALL/LBL patients were retrospectively analyzed to build three novel risk stratification models through Cox proportional hazards model.
Forty-seven mutated genes were identified. Here, 73.3% of patients had at least one mutation, and 36.7% had ≥3 mutations. The genes with higher mutation frequency were , , and . The most frequently altered signaling pathways were NOTCH pathway, transcriptional regulation pathway, and DNA methylation pathway. Age (45 years old), platelet (PLT) (50 G/L), actate dehydrogenase (LDH) (600 U/L), response in D19-BMR detection, TP53 and cell cycle signaling pathway alterations, and hematopoietic stem cell transplantation (HSCT) were integrated into a risk stratification model of event-free survival (EFS). Age (45 years old), white blood cell (WBC) count (30 G/L), response in D19-BMR detection, TP53 and cell cycle signaling pathway alterations, and HSCT were integrated into a risk stratification model of overall survival (OS). According to our risk stratification models, the 1-year EFS and OS rates in the low-risk group were significantly higher than those in the high-risk group.
Our risk stratification models exhibited good prognostic roles in adult T-ALL/LBL patients and might guide individualized treatment and ultimately improve their outcomes.
成人T细胞急性淋巴细胞白血病（T-ALL）是一种预后较差的异质性恶性肿瘤。然而，准确的预后分层因素仍不清楚。
收集90例成人T细胞急性淋巴细胞白血病/淋巴瘤（T-ALL/LBL）患者的数据。回顾性分析通过下一代测序检测到的基因突变及临床特征与T-ALL/LBL患者预后的相关性，通过Cox比例风险模型建立三个新的风险分层模型。
共鉴定出47个突变基因。其中，73.3%的患者至少有一个突变，36.7%的患者有≥3个突变。突变频率较高的基因有 、 和 。最常改变的信号通路是NOTCH通路、转录调控通路和DNA甲基化通路。年龄（45岁）、血小板（PLT）（50 G/L）、乳酸脱氢酶（LDH）（600 U/L）、D19-BMR检测反应、TP53和细胞周期信号通路改变以及造血干细胞移植（HSCT）被纳入无事件生存期（EFS）风险分层模型。年龄（45岁）、白细胞（WBC）计数（30 G/L）、D19-BMR检测反应、TP53和细胞周期信号通路改变以及HSCT被纳入总生存期（OS）风险分层模型。根据我们的风险分层模型，低风险组的1年EFS和OS率显著高于高风险组。
我们的风险分层模型在成人T-ALL/LBL患者中显示出良好的预后作用，可能指导个体化治疗并最终改善其预后。
