初诊时血小板计数对非 APL 急性髓系白血病患者治疗结果的影响。

Influence on therapeutic outcome of platelet count at diagnosis in patients with de novo non-APL acute myeloid leukemia.

机构信息

Department of Hematology, Nanfang Hospital, Southern Medical University, 510515, Guangzhou, Guangdong, China.

School of Medicine, Zhengzhou University, 450001, Zhengzhou, China.

出版信息

BMC Cancer. 2023 Oct 24;23(1):1030. doi: 10.1186/s12885-023-11543-5.

DOI:10.1186/s12885-023-11543-5

PMID:37875840

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10598966/

Abstract

BACKGROUND

Platelet (PLT) count at diagnosis plays an important role in cancer development and progression in solid tumors. However, it remains controversial whether PLT count at diagnosis influences therapeutic outcome in patients with non-acute promyelocytic leukemia (APL) acute myeloid leukemia (AML).

METHODS

This study analyzed the relationship between PLT count at diagnosis and genetic mutations in a cohort of 330 newly diagnosed non-APL AML patients. The impact of PLT count on complete remission, minimal residual disease status and relapse-free survival (RFS) were evaluated after chemotherapy or allogeneic hematopoietic stem cell transplantation (allo-HSCT).

RESULTS

Our studies showed that patients with DNMT3A mutations have a higher PLT count at diagnosis, while patients with CEBPA biallelic mutations or t(8;21)(q22; q22) translocation had lower PLT count at diagnosis. Furthermore, non-APL AML patients with high platelet count (> 65 × 10/L) at diagnosis had worse response to induction chemotherapy and RFS than those with low PLT count. In addition, allo-HSCT could not absolutely attenuated the negative impact of high PLT count on the survival of non-APL AML patients.

CONCLUSION

PLT count at diagnosis has a predictive value for therapeutic outcome for non-APL AML patients.

摘要

背景

血小板（PLT）计数在实体瘤中的诊断对于癌症的发生和进展起着重要作用。然而，PLT 计数在诊断时是否影响非急性早幼粒细胞白血病（APL）急性髓系白血病（AML）患者的治疗结果仍存在争议。

方法

本研究分析了 330 例新诊断的非 APL AML 患者队列中 PLT 计数与基因突变之间的关系。在化疗或异基因造血干细胞移植（allo-HSCT）后，评估 PLT 计数对完全缓解、微小残留病状态和无复发生存（RFS）的影响。

结果

我们的研究表明，DNMT3A 基因突变的患者在诊断时具有更高的 PLT 计数，而 CEBPA 双等位基因突变或 t（8;21）（q22;q22）易位的患者在诊断时具有更低的 PLT 计数。此外，诊断时血小板计数较高（>65×10/L）的非 APL AML 患者对诱导化疗的反应和 RFS 较差，而 PLT 计数较低的患者则较差。此外，allo-HSCT 并不能完全减弱高 PLT 计数对非 APL AML 患者生存的负面影响。