Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, People's Republic of China; Shandong Key Laboratory of Immunohematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, People's Republic of China.
Department of Hematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, People's Republic of China; Shandong Key Laboratory of Immunohematology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, People's Republic of China.
Clin Chim Acta. 2024 Feb 1;554:117789. doi: 10.1016/j.cca.2024.117789. Epub 2024 Jan 19.
Gene mutations are a pivotal component of the pathogenesis of MDS, and they hold profound prognostic significance for predicting treatment responses and survival outcomes. However, reports about mutation patterns in Chinese MDS patients are limited. In this study, we analyzed the genetic mutation of 23 genes in 231 patients with MDS using next-generation sequencing (NGS) technology, and explored the characteristics of gene mutations in MDS patients and their associations with clinical outcomes, survival, and transformation outcomes. Our results showed that 68.83% patients had at least one gene mutation, and the most common mutations were ASXL1 (21.65%), SF3B1 (17.32%), U2AF1 (16.02%), TET2 (14.72%) and TP53 (8.66%). We also showed that the genetic mutations of TP53, U2AF1 and DNMT3A are independent risk factors for death in patients with MDS, and the ETV6 gene mutation was an independent risk factor for the transformation of MDS patients to AML through the univariate and multivariate Cox regression analysis model. Additionally, the study developed a risk score based on gene mutation data that demonstrated robust predictive capability and stability for the overall survival of MDS patients. Our research provided a strong theoretical basis for the establishment of personalized treatment and prognostic risk assessment models for Chinese MDS patients.
基因突变是 MDS 发病机制的关键组成部分,它们对预测治疗反应和生存结果具有深远的预后意义。然而,关于中国 MDS 患者突变模式的报告有限。在这项研究中,我们使用下一代测序 (NGS) 技术分析了 231 例 MDS 患者的 23 个基因的遗传突变,并探讨了 MDS 患者基因突变的特征及其与临床结局、生存和转化结局的关系。我们的研究结果显示,68.83%的患者至少有一个基因突变,最常见的突变为 ASXL1(21.65%)、SF3B1(17.32%)、U2AF1(16.02%)、TET2(14.72%)和 TP53(8.66%)。我们还发现,TP53、U2AF1 和 DNMT3A 的基因突变是 MDS 患者死亡的独立危险因素,ETV6 基因突变是 MDS 患者向 AML 转化的独立危险因素,通过单因素和多因素 Cox 回归分析模型。此外,该研究基于基因突变数据开发了一个风险评分,该评分对 MDS 患者的总生存具有强大的预测能力和稳定性。我们的研究为建立中国 MDS 患者的个体化治疗和预后风险评估模型提供了强有力的理论依据。