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伴有突变的CD7阳性白血病原始细胞预示急性髓系白血病患者预后不良。

CD7-positive leukemic blasts with mutations predict poor prognosis in patients with acute myeloid leukemia.

作者信息

Bai Yanliang, Sun Xiaobai, Li Mengyi, Niu Xiaona, Cao Weijie, Niu Junwei, Xiao Xingjun, Chen Yuqing, Sun Kai

机构信息

Department of Hematology, Zhengzhou University People's Hospital and Henan Provincial People's Hospital, Zhengzhou, China.

Department of Hematology, Nanyang Second General Hospital, Nanyang, China.

出版信息

Front Oncol. 2024 Mar 21;14:1342998. doi: 10.3389/fonc.2024.1342998. eCollection 2024.

Abstract

BACKGROUND

mutations can be detected in premalignant hematopoietic stem cells and are primarily associated with clonal hematopoiesis of indeterminate potential; however, current evidence does not support assigning them to a distinct European Leukemia Net (ELN) prognostic risk stratification. CD7 is a lymphoid antigen expressed on blasts in approximately 30% of acute myeloid leukemia (AML), and its role in AML remains unclear and depends on subgroup evaluation. This study investigated the prognostic value of mutation combined with CD7 expression in AML.

METHODS

We retrospectively analyzed the clinical data of 297 newly diagnosed non-M3 AML patients. According to the mutation and CD7 expression in AML cells, patients were divided into the -mutated/CD7-positive (CD7+), -mutated/CD7-negative (CD7-), -wild-type/CD7+, and -wild-type/CD7- groups.

RESULTS

The -mutated/CD7+ group had lower complete remission rates and higher relapse rates. Importantly, these patients had significantly shorter overall survival (OS) and relapse-free survival (RFS). Furthermore, multivariate analysis showed that CD7+ with mutation was an independent risk factor for OS and RFS.

CONCLUSION

CD7+ with mutation predicts a poor prognosis in AML patients, and the immunophenotype combined with molecular genetic markers can help to further refine the current risk stratification of AML.

摘要

背景

在前体恶性造血干细胞中可检测到突变,这些突变主要与潜在意义未明的克隆性造血相关;然而,目前的证据并不支持将它们归入欧洲白血病网络(ELN)的特定预后风险分层。CD7是一种淋巴细胞抗原,约30%的急性髓系白血病(AML)原始细胞可表达该抗原,其在AML中的作用仍不清楚,且取决于亚组评估。本研究调查了AML中 突变联合CD7表达的预后价值。

方法

我们回顾性分析了297例新诊断的非M3 AML患者的临床资料。根据AML细胞中的 突变和CD7表达情况,将患者分为 -突变/CD7阳性(CD7+)、 -突变/CD7阴性(CD7-)、 -野生型/CD7+和 -野生型/CD7-组。

结果

-突变/CD7+组的完全缓解率较低,复发率较高。重要的是,这些患者的总生存期(OS)和无复发生存期(RFS)显著缩短。此外,多因素分析显示, 突变伴CD7+是OS和RFS的独立危险因素。

结论

突变伴CD7+预示AML患者预后不良,免疫表型联合分子遗传标记有助于进一步细化当前AML的风险分层。

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