Correlation between myeloperoxidase expression and gene alterations and prognosis in acute myeloid leukemia
10.3760/cma.j.issn.0253-2727.2019.01.008
- VernacularTitle: 髓过氧化物酶表达与急性髓系白血病基因突变和预后的相关性研究
- Author:
Xiaoyan DONG
1
;
Yulong LI
;
Li JIANG
;
Chengye WU
;
Baojun SHANG
;
Lin ZHANG
;
Wei CHENG
;
Zunmin ZHU
Author Information
1. Institute of Hematology, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou 450003, China
- Publication Type:Journal Article
- Keywords:
Lukemia, myeloid, acute;
Myeloperoxidase;
Prognosis;
Mutation
- From:
Chinese Journal of Hematology
2019;40(1):40-45
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the percentage of myeloperoxidase (MPO)-positive acute myeloid leukemia (AML) blast cells, and to explore the correlation of MPO expression with the clinical features, gene alterations, therapeutic response and prognosis of AML.
Methods:The expressions of MPO in BM blasts cells of 233 newly diagnosed AML were retrospectived analyzed, they were divided into two groups using the percentage of MPO-positive blast [low (≤70%) and high (>70%)], clinical features, gene alterations, chemotherapy efficacy and prognosis were compared between the two groups.
Results:①Of the 233 patients, 121(51.9%) were in the low MPO group, and the rest 112(48.1%) in the high MPO group. Favorable-risk group according NCCN guidelines of AML was always MPO-high (χ2=32.773, P<0.001), while MPO-low was closely related to poor-risk (χ2=7.078, P=0.008); ②DNMT3A mutation (χ2=6.905, P=0.009), spliceosome genes mutation (SF3B1/SRSF2/U2AF1) (χ2=5.246, P=0.022), RUNX1 mutation (χ2=4.577, P=0.032), ASXL1 mutation (χ2=7.951, P=0.005) and TP53 mutation (P=0.004) were more likely to be seen in the low MPO group, while C-KIT mutation (χ2=8.936, P=0.003) and CEBPA mutation (χ2=12.340, P<0.001) were more frequent in the high MPO group, especially CEBPA double mutation; ③The rates of first complete remission in the low MPO group were significantly lower than that in the high MPO group (38.8% vs 68.1%, χ2=15.197, P<0.001). Multivariate analysis showed that low MPO positivity significantly affected the CR1 unfavourably. ④The overall survival (OS) and the progression-free survival (PFS) were significantly worse in the low MPO group (18.0% vs 89.4% for OS, and 11.5% vs 56.7% for PFS, P<0.001). Multivariate analysis disclosed that the low number of MPO was significantly unfavourable prognostic factor. ⑤The low MPO group still showed a worse survival even when restricted to the patients with normal karyotype, the OS and the PFS were 31.1% and 18.8% respectively.
Conclusions:AML with different MPO expression percentage had a unique gene mutation spectrum. Low expression of MPO was an independent risk factor for CR1, OS and PFS in AML patients, which may be a simple and highly significant factor for AML patients when evaluating the therapeutic efficacy and prognosis.
