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急性髓系白血病:新突变及其临床意义。

Acute myeloid leukemia: novel mutations and their clinical implications.

作者信息

Makkar Harshita, Majhi Ravi Kumar, Goel Harsh, Gupta Aditya Kumar, Chopra Anita, Tanwar Pranay, Seth Rachna

机构信息

Division of Pediatric Oncology, Department of Pediatrics, All India Institute of Medical Sciences New Delhi 110029, India.

Laboratory Oncology Unit, Dr. B.R.A. IRCH, All India Institute of Medical Sciences New Delhi 110029, India.

出版信息

Am J Blood Res. 2023 Feb 15;13(1):12-27. eCollection 2023.

Abstract

Acute myeloid leukemia (AML) is a heterogenous and challenging hematological malignancy with suboptimal outcomes. The implications of advanced technologies in the genetic characterization of AML have enhanced the understanding of individualized patient risk, which has also led to the development of new therapeutic strategies. A comprehensive study of novel mutations is essential to moderate the complicacies in patient management and achieve optimal outcomes in AML. In this review, we summarized the clinical relevance of important novel mutations, including and , which impact the prognosis of AML. mutation can lead to DNA hypermethylation, and gene fusion, and mutation in disrupts hematopoietic transcription machinery, downregulation aggravates the disease, and mutation confers resistance to chemotherapy. mutation influences the RAS-MAPK signaling pathway, and alters the splicing of downstream mRNA. The systemic influence of these mutations has adverse consequences. Therefore, extensive research on novel mutations and their mechanism of action in the pathogenesis of AML is vital. This study lays out the perspective of expanding the apprehension about AML and novel drug targets. The combination of advanced genetic techniques, risk stratification, ongoing improvements, and innovations in treatment strategy will undoubtedly lead to improved survival outcomes in AML.

摘要

急性髓系白血病(AML)是一种异质性且具有挑战性的血液系统恶性肿瘤,治疗效果欠佳。先进技术在AML基因特征分析中的应用加深了对患者个体风险的理解,也推动了新治疗策略的发展。全面研究新突变对于缓解AML患者管理中的复杂性并实现最佳治疗效果至关重要。在本综述中,我们总结了重要新突变的临床相关性,包括[具体突变1]和[具体突变2]等,这些突变会影响AML的预后。[具体突变1]可导致DNA高甲基化以及[基因融合情况],[具体突变2]中的突变会破坏造血转录机制,[基因3]下调会使疾病加重,[具体突变3]赋予对化疗的抗性。[具体突变4]影响RAS-MAPK信号通路,[具体突变5]改变下游mRNA的剪接。这些突变的系统性影响会产生不良后果。因此,广泛研究AML发病机制中的新突变及其作用机制至关重要。本研究阐述了拓展对AML及新药物靶点认识的观点。先进基因技术、风险分层、持续改进以及治疗策略创新的结合无疑将改善AML患者的生存结局。

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