Expression of gene and its prognostic value in patients with acute myeloid leukemia.
- Author:
Dongfen DU
1
;
Lixia ZHU
1
;
Yungui WANG
2
;
Xiujin YE
1
Author Information
1. Department of Hematology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
2. Department of Hematology and Institute of Hematology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
- Publication Type:Journal Article
- MeSH:
Disease-Free Survival;
Gene Expression Profiling;
Humans;
Kaplan-Meier Estimate;
Leukemia, Myeloid, Acute;
diagnosis;
genetics;
mortality;
Mutation;
Nuclear Proteins;
genetics;
Prognosis;
WT1 Proteins;
genetics;
fms-Like Tyrosine Kinase 3;
genetics
- From:
Journal of Zhejiang University. Medical sciences
2019;48(1):50-57
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To investigate the expression of Wilms'tumor 1 () gene in patients with acute myeloid leukemia (AML), and to explore its application in predicting prognosis of AML in patients with wild or mutated nucleophosmin 1() and Fms-like tyrosine kinase 3-internal tandem duplication ().
METHODS:One hundred and sixty-seven newly diagnosed AML patients(exclued M3 type) were enrolled in this study. The survival of patients were analyzed with Kaplan-Meier method. The clinical data, laboratory findings and the survival of patients were analyzed and compared between patients with high expression (high- group) and those with low expression (low- group), as well as among the patients with or wild type and mutants.
RESULTS:The overall response rates (ORR) in high- and low- groups were 65.9% (83/126) and 95.1% (39/41), respectively (<0.01). Compared with the low- group, the high- group had lower 2-y overall survival (OS) rate (46.1% vs. 75.2%, <0.05) and 2-y disease free survival (DFS) rate (43.5% vs. 68.5%, <0.05). After induction chemotherapy, the patients with decreased gene expression ≥ 1log was associated with higher ORR and 2-y OS rate (all <0.05), but the advantage of 2-y DFS rate was not shown (>0.05). In patients with wild type, the high- group had inferior ORR and 2-y OS rate (all <0.05), while in the patients with wild type, the high- group had inferior ORR, 2-y OS rate and 2-y DFS rate (all <0.05). In patients with or FLT3 -ITD mutations, the expression had no significantly predicting values in treatment efficacy and survival (all >0.05).
CONCLUSIONS: gene overexpression indicated poor prognosis of AML patients; the patients with decreased gene expression ≥ 1 log after the first induction therapy show better prognosis than those with<1 log. The gene expression level at diagnosis can be used as an unfavorable prognostic factor for AML patients with or wild types.
