果糖二磷酸醛缩酶A在急性髓系白血病患者骨髓中的表达及其对预后的影响  

Expression of fructose bisphosphate aldolase A in bone marrow of patients with acute myeloid leukemia and its influence on prognosis

作　　者：马平[1] 田亮[1] 史利欢 周建文[1] 毛彦娜[1] 刘炜[1] 何永艳 甘思林[2] 孙慧[2] Ma Ping;Tian Liang;Shi Lihuan;Zhou Jianwen;Mao Yanna;Liu Wei;He Yongyan;Gan Silin;Sun Hui(Deparment of Hematology and Oncology,Children's Hospital Affliated to Zhengzhou University,Zhengzhou 450066,China;Department of Hematology,the First Affliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学附属儿童医院血液肿瘤科,郑州450066 [2]郑州大学第一附属医院血液科,郑州450052

出　　处：《白血病．淋巴瘤》2022年第11期664-668,共5页Journal of Leukemia & Lymphoma

摘　　要：目的:探讨果糖二磷酸醛缩酶A(ALDOA)在急性髓系白血病(AML)患者骨髓中的表达及其与患者临床特征和预后之间的关系。方法:收集2013年1月至2015年12月郑州大学第一附属医院及郑州大学附属儿童医院90例AML(非急性早幼粒细胞白血病)患者(AML组)及18例异基因造血干细胞移植供者(正常对照组)骨髓标本,应用实时荧光定量聚合酶链反应(qRT-PCR)检测ALDOA mRNA相对表达量。对患者临床资料进行回顾性分析,根据疗效与随访结果将患者分为持续完全缓解组和难治复发组。分析AML组与正常对照组及持续完全缓解组与难治复发组之间ALDOA mRNA相对表达量的差异。应用单因素及多因素Cox比例风险模型分析AML患者预后的影响因素。结果:AML组ALDOA mRNA相对表达量高于正常对照组(5.71±0.44比1.10±0.08),差异有统计学意义(t=4.74,P<0.001);难治复发组ALDOA mRNA相对表达量高于持续完全缓解组(6.69±0.67比4.30±0.36),差异有统计学意义(t=2.79,P<0.001)。不同白细胞计数、骨髓原始细胞比例及1个疗程诱导治疗是否完全缓解的ALDOA mRNA高表达和低表达患者比例比较,差异均有统计学意义(均P<0.05)。ALDOA高表达患者总生存差于低表达患者(χ^(2)=5.59,P=0.018)。多因素分析显示,白细胞计数、预后分层、1个疗程诱导治疗是否达完全缓解、ALDOA表达均是AML患者死亡的独立影响因素(均P<0.05)。结论:ALDOA在AML发生、发展中可能起重要作用,骨髓中ALDOA表达水平可作为AML患者预后评估的指标,并可能为AML治疗的潜在靶点。Objective:To explore the expression of fructose bisphosphate aldolase A(ALDOA)in the bone marrow of patients with acute myeloid leukemia(AML)and the correlation with clinical features and prognosis.Methods:The bone marrow samples of 90 newly diagnosed AML(non-acute promyelocytic leukemia)patients and 18 allogeneic hematopoietic stem cell transplantation donors who were treated from January 2013 to December 2015 in the First Affiliated Hospital of Zhengzhou University and the Children's Hospital Affiliated to Zhengzhou University were collected.The relative expression level of ALDOA mRNA in bone marrow samples was detected by using real-time quantitative polymerase chain reaction(qRT-PCR).Clinical data of these patients were retrospectively analyzed,and the patients were divided into continuous complete remission(CR)group and refractory recurrent(RR)group according to the clinical response and follow-up results.The differences of the relative expression level of ALDOA mRNA between AML group and the normal control group,CR group and RR group were analyzed.Univariate and multivariate Cox regression risk model were used for analysis of factors influencing prognosis of AML patients.Results:The relative expression level of ALDOA mRNA in AML group was higher than that in normal control group[(5.71±0.44)vs.(1.10±0.08),t=4.74,P<0.001].The relative expression level of ALDOA mRNA in the RR group was higher than that in the CR group[(6.69±0.67)vs.(4.30±0.36),t=2.79,P<0.001].In addition,there were statistically significant differences in the proportion of patients with ALDOA mRNA high expression and those with ALDOA mRNA low expression stratified by the number of white blood cell,the proportion of bone marrow blasts and whether complete remission could be achieved or not after 1 course of induction therapy(all P<0.05).Overall survival in patients with ALDOA high expression was worse than that in patients with ALDOA low expression(χ^(2)=5.59,P=0.018).Multivariate analysis showed that white blood cell count,prognosis strat

关 键 词：白血病 髓系 急性 果糖二磷酸醛缩酶A 糖酵解 预后 

分 类 号：R733.71[医药卫生—肿瘤]