DTA突变在初诊急性髓系白血病患者中的预后价值  

Prognostic Value of DTA Mutations in Patients with Newly Diagnosed Acute Myeloid Leukemia

作　　者：陈惠娟 曹阳[1] 缪颖洁 周怡芳 刘月 顾伟英[1] CHEN Hui-Juan;CAO Yang;MIAO Ying-Jie;ZHOU Yi-Fang;LIU Yue;GU Wei-Ying(Department of Hematology,The Third Affiliated Hospital of Soochow University,The First People′s Hospital of Changzhou,Changzhou)

机构地区：[1]苏州大学附属第三医院,常州市第一人民医院血液科,江苏常州213003

出　　处：《中国实验血液学杂志》2024年第4期993-998,共6页Journal of Experimental Hematology

基　　金：常州市“十四五”卫生领军人才工程资助项目(KY20221336);江苏省卫生健康委员会重点项目(ZD2021043)。

摘　　要：目的:探讨DTA(DNMT3A、TET2、ASXL1)突变在非M3型急性髓系白血病(AML)患者中的预后意义。方法:回顾性分析2018年1月至2022年4月就诊于常州市第一人民医院的180例AML患者的临床资料,采用二代测序技术检测患者的150种基因突变情况,采用log-rank检验和Cox回归模型分析影响预后的因素。结果:180例AML患者中,有83例(46.1%)患者检出DTA基因突变。与无DTA突变组相比,DTA突变组患者年龄更大(P<0.001)。DTA突变型组较无DTA突变组的中位总生存时间(OS)及无病生存时间(DFS)均明显缩短(P<0.05)。多因素分析结果显示,年龄≥60岁(P<0.001)、伴DTA突变(P=0.018)、预后中等(相对于预后良好)(P=0.005)是影响患者OS的独立危险因素。结论:伴DTA突变的AML患者年龄偏大,中位OS和中位DFS时间短,预后不佳。Objective:To investigate the prognostic significance of DTA(DNMT3A,TET2,ASXL1)gene mutations in patients with non-M3 acute myeloid leukemia(AML).Methods:The clinical data of 180 newly diagnosed AML patients hospitalized in the First People's Hospital of Changzhou from January 2018 to April 2022 were retrospectively analyzed.Next-generation sequencing technology was used to detect 150 gene mutations in the patients,and log-rank tests and Cox regression models were used to analyze the prognostic factors.Results:DTA gene mutations were detected in 83(46.1%)of 180 AML patients.Compared to patients without DTA mutations,patients with DTA mutations were significantly older(P<0.001).The median overall survival(OS)time and disease-free survival(DFS)time in the DTA mutation group were significantly shorter than those in the group without DTA mutation(both P<0.05).Multivariate analysis showed that age≥60 years(P<0.001),with DTA mutation(P=0.018),and intermediate-risk(relative to favorable-risk)(P=0.005)were independent risk factors for OS in AML patients.Conclusion:AML patients with DTA mutations are relatively older,with shorter median OS time and DFS time,and poor prognosis.

关 键 词：DTA突变 克隆性造血 急性髓系白血病 预后 

分 类 号：R733.71[医药卫生—肿瘤]