Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, Jiangsu, China.
Department of Hematology, Affiliated Changzhou Second Hospital of Nanjing Medical University, Changzhou, 213003, Jiangsu, China.
Clin Transl Oncol. 2023 Jun;25(6):1719-1728. doi: 10.1007/s12094-022-03069-2. Epub 2023 Jan 30.
There is growing evidence that methylation-associated genes (MAGs) play an important role in the prognosis of acute myeloid leukemia (AML) patients. Thus, the aim of this research was to investigate the impact of MAGs in predicting the outcomes of AML patients.
The expression profile and clinical information of patients were downloaded from public databases. A novel prognostic model based on 7 MAGs was established in the TCGA training cohort and validated in the GSE71014 dataset. To validate the clinical implications, the correlation between MAGs signature and drug sensitivity was further investigated.
76 genes were screened out by the univariate Cox regression and significantly enriched in multiple methylation-related pathways. After filtering variables using LASSO regression analysis, 7 MAGs were introduced to construct the predictive model. The survival analysis showed overall survival of patients with the high-risk score was considerably poorer than that with the low-risk score in both the training and validating cohorts (p < 0.01). Furthermore, the risk score system as a prognostic factor also worked in the intermediate-risk patients based on ELN-2017 classification. Importantly, the risk score was demonstrated to be an independent prognostic factor for AML in the univariate and multivariate Cox regression analysis. Interestingly, GSEA analysis revealed that multiple metabolism-related pathways were significantly enriched in the high-risk group. Drug sensitivity analysis showed there was a significant difference in sensitivity of some drugs between the two groups.
We developed a robust and accurate prognostic model with 7 MAGs. Our findings might provide a reference for the clinical prognosis and management of AML.
越来越多的证据表明,甲基化相关基因(MAGs)在急性髓系白血病(AML)患者的预后中起着重要作用。因此,本研究旨在探讨 MAGs 在预测 AML 患者预后中的作用。
从公共数据库中下载患者的表达谱和临床信息。在 TCGA 训练队列中建立了一个基于 7 个 MAGs 的新预后模型,并在 GSE71014 数据集上进行了验证。为了验证临床意义,进一步研究了 MAGs 特征与药物敏感性之间的相关性。
通过单因素 Cox 回归筛选出 76 个基因,并在多个甲基化相关途径中显著富集。通过 LASSO 回归分析筛选变量后,引入 7 个 MAGs 构建预测模型。生存分析显示,在训练和验证队列中,高风险评分患者的总体生存率明显低于低风险评分患者(p<0.01)。此外,风险评分系统作为预后因素在基于 ELN-2017 分类的中危患者中也有效。重要的是,风险评分在单因素和多因素 Cox 回归分析中均被证明是 AML 的独立预后因素。有趣的是,GSEA 分析显示,高危组中多个代谢相关途径显著富集。药物敏感性分析显示,两组对某些药物的敏感性存在显著差异。
我们建立了一个基于 7 个 MAGs 的稳健而准确的预后模型。我们的研究结果可能为 AML 的临床预后和管理提供参考。