Kolesnikova Maria A, Sen'kova Aleksandra V, Pospelova Tatiana I, Zenkova Marina A
City Hematology Center, Novosibirsk 630051, Russia.
Institute of Chemical Biology and Fundamental Medicine SB RAS, Novosibirsk 630090, Russia.
J Pers Med. 2023 Aug 7;13(8):1234. doi: 10.3390/jpm13081234.
Acute myeloid leukemia (AML) is a hematopoietic disorder characterized by the malignant transformation of bone marrow-derived myeloid progenitor cells with extremely short survival. To select the optimal treatment options and predict the response to therapy, the stratification of AML patients into risk groups based on genetic factors along with clinical characteristics is carried out. Despite this thorough approach, the therapy response and disease outcome for a particular patient with AML depends on several patient- and tumor-associated factors. Among these, tumor cell resistance to chemotherapeutic agents represents one of the main obstacles for improving survival outcomes in AML patients. In our study, a new prognostic scale for the risk stratification of AML patients based on the detection of the sensitivity or resistance of tumor cells to chemotherapeutic drugs in vitro as well as mRNA/P-glycoprotein expression, tumor origin (primary or secondary), cytogenetic abnormalities, and aberrant immunophenotype was developed. This study included 53 patients diagnosed with AML. Patients who received intensive or non-intensive induction therapy were analyzed separately. Using correlation, ROC, and Cox regression analyses, we show that the risk stratification of AML patients in accordance with the developed prognostic scale correlates well with the response to therapy and represents an independent predictive factor for the overall survival of patients with newly diagnosed AML.
急性髓系白血病(AML)是一种造血系统疾病,其特征为骨髓来源的髓系祖细胞发生恶性转化,生存期极短。为了选择最佳治疗方案并预测治疗反应,需根据遗传因素及临床特征将AML患者分层为不同风险组。尽管采用了这种全面的方法,但特定AML患者的治疗反应和疾病转归仍取决于多种与患者和肿瘤相关的因素。其中,肿瘤细胞对化疗药物的耐药性是改善AML患者生存结局的主要障碍之一。在我们的研究中,基于体外检测肿瘤细胞对化疗药物的敏感性或耐药性以及mRNA/P-糖蛋白表达、肿瘤起源(原发性或继发性)、细胞遗传学异常和异常免疫表型,开发了一种用于AML患者风险分层的新预后量表。本研究纳入了53例诊断为AML的患者。分别对接受强化或非强化诱导治疗的患者进行了分析。通过相关性分析、ROC分析和Cox回归分析,我们发现,根据所开发的预后量表对AML患者进行风险分层与治疗反应密切相关,并且是新诊断AML患者总生存的独立预测因素。