Clinical significance of monitoring NUP98::NSD1 fusion genes before and after allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.issn.0253-2727.2023.12.007
- VernacularTitle:急性髓系白血病患者异基因造血干细胞移植前后监测NUP98::NSD1融合基因的临床意义
- Author:
Yake SHANG
1
;
Xinan PAN
;
Yingjun CHANG
;
Yaqin QIN
;
Yu WANG
;
Chenhua YAN
;
Yuqian SUN
;
Xiaojun HUANG
;
Xiaosu ZHAO
Author Information
1. 北京大学人民医院，北京大学血液病研究所，国家血液系统疾病临床医学研究中心，造血干细胞移植治疗血液病北京市重点实验室，北京 100044
- Keywords:
Acute myeloid leukemia;
Allogeneic hematopoietic stem cell transplantation;
Measurable residual disease;
Relapse;
Fusion gene;
NUP98::NSD1
- From:
Chinese Journal of Hematology
2023;44(12):1010-1015
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aimed to observe the dynamic changes of NUP98::NSD1 expression before and after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Moreover, the clinical value of measurable residual disease (MRD) was analyzed.Methods:Sixteen AML patients who were diagnosed with the NUP98::NSD1 fusion gene and received allo-HSCT at Peking University People’s Hospital were included. The NUP98::NSD1 fusion gene and leukemia-associated immunophenotype (LAIP) were monitored before and after transplantation to evaluate their MRD status.Results:The median follow-up time for all patients was 526 days (139-1136 days) , with four patients (25.0%) experiencing hematological recurrence at a median of 474 days (283-607 days) after transplantation. Three patients (18.8%) died, two of whom (12.5%) died of leukemia recurrence. The median expression level of NUP98::NSD1 in newly diagnosed patients with complete data was 78.5% (18.9%-184.4%) at the time of initial diagnosis. The recurrence rate was higher in NUP98::NSD1-positive patients after transplantation, with 44.4% of patients experiencing recurrence, whereas no recurrence occurred in NUP98::NSD1-negative patients after transplantation. The area under the receiver operating characteristic curve predicted by the NUP98::NSD1 level after transplantation was 1.000 (95% confidence interval: 1.000-1.000, P=0.003) . Among the four patients with recurrence, NUP98::NSD1 was more sensitive than flow cytometry residual (FCM) and Wilms’ tumor gene 1 (WT1) . Conclusions:The NUP98::NSD1 fusion gene can be used to evaluate the MRD status of allo-HSCT. NUP98::NSD1-positive patients after transplantation have a high relapse rate and poor prognosis. NUP98::NSD1 was more sensitive than FCM and WT1 in predicting posttransplant relapse.
