Prognostic significance of DEK-NUP214 fusion gene in patients with acute myeloid leukemia after allogeneic hematopoietic stem cell transplantation
10.3760/cma.j.cn112138-20201015-00868
- VernacularTitle:急性髓系白血病患者异基因造血干细胞移植后监测DEK-NUP214融合基因的预后意义
- Author:
Mengge GAO
1
;
Qiang FU
;
Yazhen QIN
;
Yingjun CHANG
;
Yu WANG
;
Chenhua YAN
;
Lanping XU
;
Xiaohui ZHANG
;
Xiaojun HUANG
;
Xiaosu ZHAO
Author Information
1. 北京大学人民医院血液科 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 100044
- Keywords:
Hematopoietic stem cell transplantation;
Leukemia;
Gene fusion;
DEK-NUP214
- From:
Chinese Journal of Internal Medicine
2021;60(10):868-874
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the dynamic change and clinical impact of DEK-NUP214 fusion gene in patients with acute myeloid leukemia (AML) receiving allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:Real-time quantitative polymerase chain reaction (RQ-PCR) and multicolor flow cytometry (FCM) were used to detect DEK-NUP214 gene expression and leukemia-associated immunophenotype (LAIP) in 15 newly diagnosed patients with positive DEK-NUP214 and receiving allo-HSCT from September 2012 to September 2017 at Peking University People′s Hospital. The clinical outcome was analyzed using Kaplan-Meier survival curves. The impact of DEK-NUP214 expression was analyzed by log-rank test.Results:The subjects were followed-up with a median period of 657 (62-2 212) days. The median DEK-NUP214 expression level at diagnosis was 488% (274%-1 692%). Thirteen patients achieved complete remission before allo-HSCT. Thirteen patients had a residual DEK-NUP214 expression of 0.38% (0.029%-738.9%) before allo-HSCT. After allo-HSCT, DEK-NUP214 expression in 9/13 patients remained positive, which dropped by around 500 folds (5.7-5 663.0 folds) within a month post-transplant. Five patients died and 2 patients relapsed. The 3-year cumulative incidence of relapse in patients with positive DEK-NUP214 before transplant was 17.5%±11.3% and the 3-year overall survival was 60.5%±13.8%. After allo-HSCT, DEK-NUP214-negative patients had a better outcome.Conclusion:Quantitative monitor of DEK-NUP214 fusion gene could be a sensitive indicator of MRD status after allo-HSCT.
