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伴有DNMT3A和克隆性造血相关基因突变的急性髓系白血病的临床病理及全基因组甲基化分析

Clinicopathological and global methylation profiling of acute myeloid leukemia with mutations in and clonal hematopoiesis-related genes.

作者信息

Elhodaky Mostafa, Duckett Drew, Santana-Santos Lucas, Oh Timothy S, Abaza Yasmin, Sukhanova Madina, Lu Xinyan, Vormittag-Nocito Erica R, Jennings Lawrence J, Gao Juehua

机构信息

Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Department of Hematology and Oncology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

出版信息

Leuk Lymphoma. 2025 Sep;66(9):1661-1668. doi: 10.1080/10428194.2025.2495105. Epub 2025 Apr 25.

Abstract

Recent studies suggest that nucleophosmin 1 ()-mutated acute myeloid leukemia (-AML) often arises from clonal hematopoiesis (CH) involving mutations in genes (, , ), which can persist during remission. This research evaluates the clinical implications of molecular profiling of CH-related genes in -AML by comparing clinical features, treatment outcomes, and methylation patterns with those of -AML lacking mutations. Findings show -AML with mutations exhibited higher WBC/peripheral blood blast counts, a lower incidence of extramedullary disease, more frequent but less -TKD mutations. However, no significant differences in clinical characteristics such as age, treatment response, or disease outcome between the groups were seen. Additionally, despite variations in methylation profiles based on disease status, no distinct differences between -positive and negative groups were observed. Notably, three probes, including one linked to the promoter, effectively differentiated disease states, highlighting the potential role of in leukemogenesis and patient survival.

摘要

近期研究表明,核磷蛋白1(NPM1)突变的急性髓系白血病(AML)通常源于涉及DNMT3A、TET2、ASXL1基因(DNMT3A、TET2、ASXL1)突变的克隆性造血(CH),这些突变在缓解期可能持续存在。本研究通过比较临床特征、治疗结果以及甲基化模式,评估CH相关基因分子谱分析在NPM1突变AML中的临床意义,与无NPM1突变的AML进行对比。研究结果显示,伴有NPM1突变的AML表现出更高的白细胞计数/外周血原始细胞计数、髓外疾病发生率较低、更频繁的FLT3-ITD但较少的NPM1-TKD突变。然而,两组之间在年龄、治疗反应或疾病转归等临床特征方面未观察到显著差异。此外,尽管基于疾病状态甲基化谱存在差异,但在NPM1阳性和阴性组之间未观察到明显差异。值得注意的是,包括一个与NPM1启动子相关的探针在内的三个探针能够有效区分疾病状态,突出了NPM1在白血病发生和患者生存中的潜在作用。

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