Li Ruo-Qi, Wen Xiao-Ling, Zhang Xia-Lin, Dong Chun-Xia, Wang Mei-Fang, Liu Xia-Xia, Huang Yan-Jun, Tan Yan-Hong, Chang Jian-Mei, Zhang Rui-Juan
Department of Hematology, The Second Hospital of Shanxi Medical University; Taiyuan 030001, Shanxi Province, China.
Department of Hematology, The Third Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Jun;31(3):628-632. doi: 10.19746/j.cnki.issn.1009-2137.2023.03.002.
To investigate the expression of mutation in acute myeloid leukemia (AML) and analyze its clinical characteristics and prognosis.
A retrospective study was conducted in 212 patients with AML who were newly diagnosed in the Second Hospital of Shanxi Medical University from January 1th 2018 to June 30th 2021, including 22 patients with mutations as mutation group and 190 patients with wild type ［66 cases of them were screened by propensity score matching (PSM), as control group］. The early efficacy and survival between the two groups were compared.
The median age of patients in the mutation group was 50(17-73) years old, and the ratio of male to female was 1.2:1 The main types were AML with maturation (11 cases) and acute myelomonocytic leukemia (9 cases). Prognostic stratification was carried out according to the risk stratification system of the European leukemia network in 2017, with 16 cases (72.73%) in the middle and high-risk group. At the initial diagnosis, the median count of white blood cell (WBC) was 44.75(1.30-368.71)×10/L, among which 15 cases (68.18%) were >10×10/L, and the median count of platelet (PLT) was 24(4-55)×10/L. T618I (68.18%) was a common mutation site, which had concomitant gene mutations, in which mutation was the most common (10 cases, 45.45%), but only existed in T618I mutation. The CR/CRi rate was 68.18% and 71.21% in the mutant group and the control group ( >0.05), the median over all survival time was 15 months and 9 months ( >0.05), and the median disease-free survival time was 8 months and 4 months ( >0.05), respectively.
Most AML patients with mutation are middle-aged patients, the main types are AML with maturation and acute myelomonocytic leukemia, and most of them have middle and high-risk prognosis. mutation may not be an independent prognostic marker for newly diagnosed AML patients.
探讨急性髓系白血病（AML）中 突变的表达情况，并分析其临床特征及预后。
对2018年1月1日至2021年6月30日在山西医科大学第二医院新诊断的212例AML患者进行回顾性研究，其中22例有 突变的患者作为突变组，190例野生型患者［其中66例经倾向评分匹配（PSM）筛选作为对照组］。比较两组的早期疗效及生存情况。
突变组患者中位年龄为50（17 - 73）岁，男女比例为1.2∶1。主要类型为成熟型AML（11例）和急性粒单核细胞白血病（9例）。按照2017年欧洲白血病网络的危险分层系统进行预后分层，中高危组16例（72.73%）。初诊时，白细胞（WBC）中位数计数为44.75（1.30 - 368.71）×10⁹/L，其中15例（68.18%）＞10×10⁹/L，血小板（PLT）中位数计数为24（4 - 55）×10⁹/L。T618I（68.18%）为常见突变位点，存在伴随基因突变，其中 突变最为常见（10例患者，45.45%），但仅存在于T618I突变中。突变组和对照组的完全缓解/血液学不完全缓解（CR/CRi）率分别为68.18%和71.21%（P＞0.05），中位总生存时间分别为15个月和9个月（P＞0.05），中位无病生存时间分别为8个月和4个月（P＞0.05）。
多数有 突变的AML患者为中年患者，主要类型为成熟型AML和急性粒单核细胞白血病，且多数预后为中高危。 突变可能不是新诊断AML患者的独立预后标志物。
