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在急性髓系白血病患者巩固治疗中,rs12459419 多态性不能预测吉妥珠单抗奥佐米星的反应:PETHEMA 组的经验。

No Evidence that rs12459419 Polymorphism Predicts Gemtuzumab Ozogamicin Response in Consolidation Treatment of Acute Myeloid Leukemia Patients: Experience of the PETHEMA Group.

机构信息

Hematology Department, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

Instituto de Investigación Sanitaria (IIS-FJD), Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.

出版信息

Dis Markers. 2022 Aug 23;2022:3132941. doi: 10.1155/2022/3132941. eCollection 2022.

Abstract

Gemtuzumab ozogamicin (GO) is a conjugate of a monoclonal antibody and calicheamicin, which has been reapproved for the treatment of acute myeloid leukemia (AML). AML patients with the rs12459419 CC genotype might benefit from the addition of GO to intensive treatment in contrast to patients with CT/TT genotypes. Nevertheless, contradictory results have been reported. We sought to shed light on the prediction of GO response in AML patients with rs12459419 polymorphism who were treated with GO in the consolidation ( = 70) or reinduction ( = 20) phase. The frequency distribution of the rs12459419 polymorphism in the complete cohort of patients was 44.4% ( = 40), 50% ( = 45), and 5.6% ( = 5) for CC, CT, and TT genotypes, respectively. Regarding the patients treated with GO for consolidation, we performed a Kaplan-Meier analysis of overall survival and relapse-free survival according to the rs12459419 polymorphism (CC vs. CT/TT patients) and genetic risk using the European Leukemia Net (ELN) 2010 risk score. We also carried out a Cox regression analysis for the prediction of overall survival, with age and ELN 2010 as covariates. We found no statistical significance in the univariate or multivariate analysis. Additionally, we performed a global Kaplan-Meier analysis for the patients treated with GO for reinduction and did not find significant differences; however, our cohort was too small to draw any conclusion from this analysis. The use of GO in consolidation treatment is included in the approval of the compound; however, evidence regarding its efficacy in this setting is lacking. Rs12459419 polymorphism could help in the selection of patients who might benefit from GO. Regrettably, in our cohort, the rs12459419 polymorphism does not seem to be an adequate tool for the selection of patients who might benefit from the addition of GO in consolidation cycles.

摘要

吉妥珠单抗奥佐米星(GO)是一种单克隆抗体和加利车霉素的结合物,已重新批准用于治疗急性髓细胞性白血病(AML)。与 CT/TT 基因型的患者相比,rs12459419CC 基因型的 AML 患者可能从强化治疗中加入 GO 中获益。然而,已经报告了矛盾的结果。我们试图阐明接受 GO 巩固(n = 70)或再诱导(n = 20)阶段治疗的 rs12459419 多态性 AML 患者中,GO 反应的预测。在患者的完整队列中,rs12459419 多态性的频率分布为 44.4%(n = 40)、50%(n = 45)和 5.6%(n = 5),分别为 CC、CT 和 TT 基因型。关于接受 GO 巩固治疗的患者,我们根据 rs12459419 多态性(CC 与 CT/TT 患者)和欧洲白血病网(ELN)2010 风险评分进行了总体生存和无复发生存的 Kaplan-Meier 分析。我们还进行了 COX 回归分析,以预测总生存率,以年龄和 ELN 2010 为协变量。我们发现单因素或多因素分析均无统计学意义。此外,我们对接受 GO 再诱导治疗的患者进行了全球 Kaplan-Meier 分析,未发现显著差异;然而,我们的队列太小,无法从该分析中得出任何结论。GO 巩固治疗的使用包含在该药物的批准中;然而,在这种情况下缺乏其疗效的证据。rs12459419 多态性可能有助于选择可能从 GO 中获益的患者。遗憾的是,在我们的队列中,rs12459419 多态性似乎不是选择可能从巩固周期中添加 GO 中获益的患者的合适工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8ea8/9427256/43404784ae6c/DM2022-3132941.001.jpg

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