1.CBCT follow-up study on alveolar bone remodeling in the anterior teeth area of adolescent patients with anterior arch protrusion after tooth extraction correction
Jueyao XIA ; Zanzan ZHANG ; Chong ZHONG ; Jing JIN ; Fengyang YU ; Jianan ZHANG ; Qunzhi FANG ; Haiping LU
Journal of Practical Stomatology 2024;40(6):799-804
Objective:To study the alveolar bone remodeling of maxillary anterior teeth after extraction treatment and 2-year recovery period in adolescent patients with maxillary anterior arch protrusion.Methods:15 adolescent patients with maxillary anterior arch protru-sion were included,2 maxillary first premolars were extracted and implant anchorage combined with sliding method were used to close the extraction gap.CBCT images were taken before treatment(T0),after treatment(T1)and 2 years of recorvery period(T2),respectively.After multi-plane reconstruction with Dophin Imaging,the alveolar bone area(ABA)changes of maxillary central incisor,lateral incisor and canine at cementoenamel junction(CEJ-3 mm),root neck,central part,and root tip were measured and recorded as TAC,TA1,TA2 and TA3 respectively.The labial palatal alveolar crest to CEJ bone height(BH)of each tooth was recorded as BCL,BCP respectively.The data were analyzed by IBM SPSS statistics 25.0.Results:In T0-T2 phase,TA1 of each tooth was reduced.In T0-T1 phase,the horizontal adsorption of teeth was significantly correlated with ΔBCP,followed by ΔTA3.In T0-T2 phase,ΔBCP,ΔTA2,ΔTA3 and the horizontal adsorption of teeth showed low negative correlation.In T0-T1 phase,the vertical reduction of teeth was significantly positively correlated with ΔTAC,followed by low correlation with ΔTA3 and ΔTA1.Conclusion:In the treatment of anterior arch protrusion after extraction correction in adolescent patients the more the vertical reduction and horizontal adsorption of teeth in the treatment phase,the more the alveolar bone thickness and height around the tooth root in the maintenance phase,which were significantly positively correlated.Reasonable control of the vertical move-ment of teeth in the alveolar bone can improve the periodontal condition around the teeth to a certain extent.
2.Development of a Prognostic Model for Overall Survival Adult Patients with Core Binding Factor Acute Myeloid Leukaemia
Lu-Yao SHI ; Ling-Ling LI ; Tao LI ; Ya-Fei LI ; Yan-Fang LIU ; Zhong-Xing JIANG ; Shu-Juan WANG ; Chong WANG
Journal of Experimental Hematology 2024;32(3):693-701
Objective:To analyze the factors affecting overall survival(OS)of adult patients with core-binding factor acute myeloid leukemia(CBF-AML)and establish a prediction model.Methods:A total of 216 newly diagnosed patients with CBF-AML in the First Affiliated Hospital of Zhengzhou University from May 2015 to July 2021 were retrospectively analyzed.The 216 CBF-AML patients were divided into the training and the validation cohort at 7:3 ratio.The Cox regression model was used to analyze the clinical factors affecting OS.Stepwise regression was used to establish the optimal model and the nomogram.Receiver operating characteristic(ROC)curve,calibration curve and decision curve analysis(DCA)were used to evaluate the model performance.Results:Age(≥ 55 years old),peripheral blood blast(≥80%),fusion gene(AML1-ETO),KIT mutations were identified as independent adverse factors for OS.The area under the ROC curve at 3-year was 0.772 and 0.722 in the training cohort and validation cohort,respectively.The predicted value of the calibration curve is in good agreement with the measured value.DCA shows that this model performs better than a single factor.Conclusion:This prediction model is simple and feasible,and can effectively predict the OS of CBF-AML,and provide a basis for treatment decision.
3.Jianpi Huayu Prescription Reverses Epithelial-Mesenchymal Transition and Angiogenesis of Hepatocellular Carcinoma by Regulating TGF-β1/Smad7 Pathway
Ying ZHANG ; Chongkai FANG ; Hanqian SHI ; Ruiwei YAO ; Jinan WANG ; Chuyao CHEN ; Chong ZHONG
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(8):1181-1190
Objective To investigate the regulatory effect of Jianpi Huayu Prescription(Ginseng Radix et Rhizoma,Poria,Atractylodis Macrocephalae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,etc.)on epithelial-mesenchymal transition(EMT)and angiogenesis of hepatocellular carcinoma through TGF-β1/Smad7 pathway.Methods(1)Hep3B tumor-bearing mouse model was established by BALB/C-nu nude mice.The mice were randomly divided into control group and Jianpi Huayu Prescription low-,medium-and high-dose groups(3.844,7.689,15.378 g·kg-1·d-1),with five mice in each group.Intragastric administration was performed once a day for 21 days.(2)Hep3B cells were divided into blank group,model group(10 ng·mL-1 TGF-β1),low-concentration group(10 ng·mL-1 TGF-β1+4 mg·mL-1 Jianpi Huayu Prescription),and high-concentration group(10 ng·mL-1 TGF-β1+6 mg·mL-1 Jianpi Huayu Prescription).After 48 hours of TGF-β1 induction,the cells were replaced with the corresponding concentration of Jianpi Huayu Prescription complete culture medium(0,4,6 mg·mL-1)and cultured for 24 hours.(3)HUVEC cells were divided into normal group,model group,Chinese medicine group,model plus Chinese medicine group.The cells in the normal group were cultured with conditioned medium without TGF-β1;the cells in the model group were cultured with conditioned medium containing TGF-β1.The cells in the Chinese medicine group were cultured in conditioned medium containing 4 mg·mL-1 Jianpi Huayu Prescription without TGF-β 1.The cells in the model plus Chinese medicine group were cultured with conditioned medium containing 4 mg·mL-1 Jianpi Huayu Prescription and TGF-β1.After 24 hours of continuous culture,the cells were collected for subsequent experiments.(4)The tumor mass index and tumor inhibition rate of subcutaneous transplantation tumor of Hep3B tumor-bearing nude mice were calculated.The expression of CD31 in subcutaneous xenografts of tumor-bearing nude mice was detected by immunofluorescence.The microvessel density of subcutaneous transplanted tumor in nude mice was detected by immunohistochemistry.The migration ability of Hep3B cells was detected by cell scratch test.Transwell assay was used to detect the invasion ability of Hep3B/HUVEC cells.The tube formation ability of HUVEC cells was detected.The expression levels of related proteins in subcutaneous transplanted tumors,Hep3B and HUVEC cells of tumor-bearing nude mice were detected by Western Blot.Results(1)Compared with the control group,the weight and tumor mass index of subcutaneous transplanted tumor in nude mice in the medium-and high-dose groups of Jianpi Huayu Prescription were significantly decreased(P<0.01).The expression of CD31 and microvessel density in subcutaneous transplanted tumors of nude mice in low-,medium-and high-dose groups were significantly decreased(P<0.05,P<0.01),the protein expressions of VE-cadherin,EphA2 and N-cadherin were significantly down-regulated(P<0.05,P<0.01),and the protein expressions of E-cadherin and Smad7 was significantly up-regulated(P<0.01).(2)Compared with the blank group,the relative migration rate of Hep3B cells in the model group was significantly increased(P<0.05),and the number of invasive cells was significantly increased(P<0.01).The protein expressions of Vimentin and N-cadherin were significantly up-regulated(P<0.01),and the protein expressions of E-cadherin and Smad7 was significantly down-regulated(P<0.01).Compared with the model group,the relative migration rate of Hep3B cells in the low-and high-concentration groups of Jianpi Huayu Prescription was significantly decreased(P<0.01),and the number of invasive cells was significantly decreased(P<0.01).The protein expressions of Vimentin and N-cadherin was significantly down-regulated(P<0.01),and the protein expressions of E-cadherin and Smad7 were significantly up-regulated(P<0.01).(3)Compared with the normal group,the number of tubular branching points formed by HUVEC cells in the model group was significantly increased(P<0.01),the length of tubular branching was significantly increased(P<0.01),and the number of invasive cells was significantly increased(P<0.01).The protein expressions of VE-cadherin and EphA2 were significantly up-regulated(P<0.01),and the protein expression of Smad7 was significantly down-regulated(P<0.01).Compared with the model group,the number of tubular branching points formed by HUVEC cells in the model plus Chinese medicine group was significantly reduced(P<0.01),the length of tubular branching was significantly shortened(P<0.01),and the number of invasive cells was significantly reduced(P<0.01).The protein expressions of VE-cadherin and EphA2 were significantly down-regulated(P<0.01),and the protein expression of Smad7 was significantly up-regulated(P<0.01).Conclusion Jianpi Huayu Prescription can significantly inhibit the growth,invasion and migration of hepatocellular carcinoma,which may be related to the regulation of EMT and angiogenesis mediated by TGF-β1/Smad7 pathway.
4.Effect of Cyr61 on Imatinib Resistance in Chronic Myeloid Leukemia and Its Mechanism.
Yan-Fang SONG ; Li LUO ; Peng-Chong SHI ; Zhao-Zhong LI ; Tai-Gang ZHANG ; Ying-Ping CAO ; Xian-Jin ZHU
Journal of Experimental Hematology 2023;31(1):1-7
OBJECTIVE:
To investigate the effect of Cyr61 on imatinib (IM) resistance in chronic myeloid leukemia (CML) and its mechanism.
METHODS:
Cyr61 level in cell culture supernatant was determined by enzyme-linked immunosorbent assay. The expression of Cyr61 and Bcl-xL were measured by real-time PCR and Western blot. Cell apoptosis was analyzed using an Annexin V-APC Kit. Expression of signal pathways related proteins was determined by Western blot.
RESULTS:
The level of Cyr61 obviously increased in K562G cells (IM resistance to CML cell line K562). Down-regulating the expression of Cyr61 decreased the resistance of K562G cells to IM and promoted IM induced apoptosis. In CML mouse model, down-regulating the expression of Cyr61 could increase the sensitivity of K562G cells to IM. The mechanism studies showed that Cyr61 mediated IM resistance in CML cells was related to the regulation of ERK1/2 pathways and apoptosis related molecule Bcl-xL by Cyr61.
CONCLUSION
Cyr61 plays an important role in promoting IM resistance of CML cells. Targeting Cyr61 or its related effectors pathways may be one of the ways to overcome IM resistance of CML cells.
Animals
;
Humans
;
Mice
;
Apoptosis
;
Drug Resistance, Neoplasm
;
Imatinib Mesylate/pharmacology*
;
K562 Cells
;
Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism*
;
Signal Transduction
5.Prognostic Significance of LPCAT1 in Adult Acute Myeloid Leukemia Patients with FAB Subtype M2.
Yu LIU ; Ya-Jun LIU ; Lu YANG ; Yu ZHANG ; Dan-Feng ZHANG ; Zhong-Xing JIANG ; Chong WANG ; Yan-Fang LIU ; Shu-Juan WANG
Journal of Experimental Hematology 2023;31(1):64-70
OBJECTIVE:
To study the prognostic value of LPCAT1 in acute myeloid leukemia (AML).
METHODS:
TaqMan-based reverse transcription-quantitative polymerase chain reaction (RT-qPCR) was used to detect relative expression of LPCAT1 in 214 newly diagnosed adult AML patients and 24 normal controls. Survival functions were estimated using the Kaplan-Meier method and were compared by the Log-rank test. A Cox proportional hazard regression model was used to identify prognostic factors.
RESULTS:
The expression level of LPCAT1 in adult AML was 34.37%(1.83%-392.63%), which was significantly lower than 92.81%(2.60%-325.84%) of normal controls (P<0.001). The prognostic significance of LPCAT1 was evaluated in 171 non-acute promyelocytic leukemia patients with complete clinical information and prognostic data. Survival analysis showed that the expression level of LPCAT1 had no significant effect on the prognosis of the whole cohort. However, in AML patients with FAB subtype M2 (AML-M2), the 2-year relapse-free survival (RFS) rate of patients with low LPCAT1 expression was 35.4%(95%CI: 0.107-0.601), which was significantly lower than 79.2%(95%CI: 0.627-0.957) of patients with high LPCAT1 expression (P=0.012). Multivariate analysis showed that low expression of LPCAT1 was an independent risk factor for RFS of AML-M2 patients (HR=0.355, 95%CI: 0.126-0.966, P=0.049).
CONCLUSION
In adult AML patients LPCAT1 shows low expression. Low LPCAT1 expression is an independent risk factor for RFS in M2-AML patients.
Humans
;
Adult
;
Prognosis
;
Leukemia, Myeloid, Acute/metabolism*
;
Survival Analysis
;
Proportional Hazards Models
;
Risk Factors
;
1-Acylglycerophosphocholine O-Acyltransferase
6.Clinical Features and Prognosis of Multiple Myeloma Patients with Secondary Primary Malignancies.
Ling-Ling LI ; Meng-Lin LI ; Yu ZHANG ; Yu LIU ; Yan-Fang LIU ; Zhong-Xing JIANG ; Shao-Qian CHEN ; Shu-Juan WANG ; Chong WANG
Journal of Experimental Hematology 2023;31(2):429-434
OBJECTIVE:
To explore the clinical characteristics and prognosis of multiple myeloma(MM) patients with secondary primary malignancies.
METHODS:
The clinical data of newly diagnosed MM patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2019 were retrospectively analyzed. The patients with secondary primary malignancies were retrieved, and their clinical features and prognosis were evaluated.
RESULTS:
A total of 1 935 patients with newly diagnosed MM were admitted in this period, with a median age of 62 (18-94) years old, of which 1 049 cases were hospitalized twice or more. There were eleven cases with secondary primary malignancies (the incidence rate was 1.05%), including three cases of hematological malignancies (2 cases of acute myelomonocytic leukemia and 1 case of acute promyelocytic leukemia) and eight cases of solid tumors (2 cases of lung adenocarcinoma, and 1 case each of endometrial cancer, esophageal squamous cell carcinoma, primary liver cancer, bladder cancer, cervical squamous cell carcinoma, and meningioma). The median age of onset was 57 years old. The median time between diagnosis of secondary primary malignancies and diagnosis of MM was 39.4 months. There were seven cases with primary or secondary plasma cell leukemia, the incidence rate was 0.67%, and the median age of onset was 52 years old. Compared with the randomized control group, the β2-microglobulin level in the secondary primary malignancies group was lower (P=0.028), and more patients were in stage I/II of ISS (P=0.029). Among the 11 patients with secondary primary malignancies, one survived, ten died, and the median survival time was 40 months. The median survival time of MM patients after the secondary primary malignancies was only seven months. All seven patients with primary or secondary plasma cell leukemia died, with a median survival time of 14 months. The median overall survival time of MM patients with secondary primary malignancies was longer than that of the patients with plasma cell leukemia (P=0.027).
CONCLUSION
The incidence rate of MM with secondary primary malignancies is 1.05%. MM patients with secondary primary malignancies have poor prognosis and short median survival time, but the median survival time is longer than that of patients with plasma cell leukemia.
Humans
;
Middle Aged
;
Aged
;
Aged, 80 and over
;
Multiple Myeloma/complications*
;
Leukemia, Plasma Cell
;
Retrospective Studies
;
Esophageal Neoplasms/complications*
;
Esophageal Squamous Cell Carcinoma/complications*
;
Prognosis
;
Neoplasms, Second Primary
7.Gene Mutation and Overexpression of Newly Diagnosed Multiple Myeloma Patients.
Yi FAN ; Shu-Juan WANG ; Yan-Fang LIU ; Chong WANG ; Ya-Fei LI ; Wei-Qiong WANG ; Qian-Qian HAO ; Dan-Feng ZHANG ; Ying-Mei LI ; Hui SUN ; Rong GUO ; Shao-Qian CHEN ; Xin-Sheng XIE ; Tao LI ; Ding-Ming WAN ; Zhong-Xing JIANG
Journal of Experimental Hematology 2022;30(1):166-169
OBJECTIVE:
To analyze the characteristics of gene mutation and overexpression in newly diagnosed multiple myeloma (NDMM) patients.
METHODS:
Bone marrow cells from 208 NDMM patients were collected and analyzed. The gene mutation of 28 genes and overexpression of 6 genes was detected by DNA sequencing. Chromosome structure abnormalities were detected by fluorescence in situ hybridization (FISH).
RESULTS:
Gene mutations were detected in 61 (29.33%) NDMM patients. Some mutations occurred in 5 or more cases, such as NRAS, PRDM1, FAM46C, MYC, CCND1, LTB, DIS3, KRAS, and CRBN. Overexpression of six genes (CCND1, CCND3, BCL-2, CCND2, FGFR3, and MYC) were detected in 83 (39.9%) patients, and cell cycle regulation gene was the most common. Single nucleotide polymorphisms (SNP) changes were detected in 169 (81.25%) patients, the TP53 P72R gene SNP (70.17%) was the most common. Abnormality in chromosome structure was correlated to gene overexpression. Compared to the patients with normal chromosome structure, patients with 14q32 deletion showed higher proportion of CCND1 overexpression. Similarly, patients with 13q14 deletion showed higher proportion of FGFR3 overexpression, whereas patients with 1q21 amplification showed higher proportion of CCND2, BCL-2 and FGFR3 overexpression.
CONCLUSION
There are multiple gene mutations and overexpression in NDMM. However, there is no dominated single mutation or overexpression of genes. The most common gene mutations are those in the RAS/MAPK pathway and the genes of cyclin family CCND are overexpression.
Chromosome Aberrations
;
Humans
;
In Situ Hybridization, Fluorescence
;
Multiple Myeloma/genetics*
;
Mutation
8.A multicenter study on childhood Hodgkin lymphoma treated with HL-2013 regimen in China.
Di Min NIE ; Qing YUAN ; Yan YU ; Chong Jun WU ; Xia GUO ; Ai Jun ZHANG ; Jun WANG ; Li Yun XIAO ; Kai Zhi WENG ; Yong Jun FANG ; Xiu Li JU ; Ju GAO ; Zhong Jin XU ; Liang Chun YANG ; Ai Guo LIU ; Yi Jin GAO
Chinese Journal of Pediatrics 2022;60(11):1172-1177
Objective: To evaluate the efficacy of the Hodgkin lymphoma (HL)-2013 regimen in the treatment of children with HL, and to investigate the prognostic factors of childhood HL. Methods: Clinical data of 145 children (aged ≤18 years) with newly diagnosed HL, treated with HL-2013 regimen in 8 tertiary referral centers for childhood cancer from August 2011 to April 2021 were analyzed retrospectively. All the diagnosis were confirmed by histopathological morphology and immunohistochemical examination. The clinical characteristics and treatment outcomes were summarized, and the patients were divided into different groups according to clinical characteristics. Kaplan-Meier method was used for survival analysis, and the comparison of survival rates between groups was performed with Log-rank test. Results: Of the 145 cases, there were 115 males and 30 females, the age at diagnosis was 7.9 (5.8, 10.6) years. Cervical lymph node enlargement (114 cases, 78.6%) was the common symptom of the disease, and 57 patients (39.3%) were accompanied by large masses. The most common pathological classification was mixed cell type (93 cases, 64.1%). According to the Ann Arbor staging system, there were 9 cases of stage Ⅰ, 62 cases of stage Ⅱ, 45 cases of stage Ⅲ, 29 cases of stage Ⅳ. According to the risk stratification: there were 14 cases of low-risk group, 76 cases of medium-risk group and 55 cases of high-risk group. Of all patients, 68 cases (46.9%) achieved an early complete remission (CR) after 2 courses of chemotherapy, and the CR rate was 93.8% (136/145) after first-line treatment. Disease recurrence or progression occurred in 22 cases (15.2%). Of all patients, 125 cases survived, 6 cases died and 14 cases were lost to follow-up. Among the survived cases, 123 cases were continuously at CR state,and the follow-up time was 55 (40, 76) months. The 5-year overall survival (OS) and event free survival (EFS) rates were (95.3±1.9)% and (84.2±3.0)% for the entire group, respectively. 5-year OS and EFS rates for patients with stage Ⅲ-Ⅳ were both lower than those for patients with stage Ⅰ-Ⅱ (χ2=6.28 and 7.58, both P<0.05), the 5-year OS and EFS rates for patients in high-risk group were both lower than those for patients in low-risk and medium-risk group (χ2=10.93, 7.79, both P<0.05). The 5-year OS rates for the patient with early CR and without early CR were 100.0% and (90.9±3.6)% (χ2=5.77, P=0.016). EFS rates for the patient with early CR (68 cases) and without early CR (77 cases) were (93.8±3.0)% and (75.8±5.0)% (χ2=8.78, P=0.003). Conclusions: HL-2013 regimen is significantly effective in the treatment of pediatric HL. However, the patients in high-risk group and those without early CR are prone to disease recurrence or progression. Stage Ⅲ-Ⅳ and without early CR were associated with worse prognosis.
Child
;
Female
;
Male
;
Humans
;
Hodgkin Disease
;
Retrospective Studies
;
Neoplasm Recurrence, Local
;
China
;
Antineoplastic Combined Chemotherapy Protocols
;
Prognosis
;
Disease-Free Survival
9.Prognostic Value of CD123 in Acute Myeloid Leukemia Patients with Intermediate Risk in Normal Karyotype.
Yu ZHANG ; Ruo-Yang LIU ; Shu-Juan WANG ; Chong WANG ; Qiu-Tang ZHANG ; Chen HE ; Xin-Sheng XIE ; Ding-Ming WAN ; Zhong-Xing JIANG ; Yan-Fang LIU
Journal of Experimental Hematology 2020;28(6):1880-1884
OBJECTIVE:
To investigate the expression of CD123 in patients with acute myeloid leukemia (AML) and its relationship between clinical features, concomitant fusion gene or gene mutation, efficacy and prognosis.
METHODS:
365 patients with newly diagnosed AML (except M3) treated in the First Affiliated Hospital of Zhengzhou University were enrolled and retrospective analysis, and multi-parameter flow cytometry was performed to detect the expression of CD123 in myeloid leukemia cell population. CD123≥20% was defined as positive. Clinical features, concomitant fusion gene or gene mutation, efficacy and prognosis of CD123
RESULTS:
The positive rate of CD123 in 365 newly diagnosed AML patients was 38.9%. Compared with the CD123
CONCLUSION
CD123 positive indicates that AML patients have higher tumor burden and are more difficult to reach remission. It is an independent risk factor for OS and EFS in patients with normal karyotype and intermediate risk, which is important to evaluate the prognosis of patients with AML without specific prognostic marker.
Humans
;
Interleukin-3 Receptor alpha Subunit
;
Karyotype
;
Leukemia, Myeloid, Acute/genetics*
;
Mutation
;
Patients
;
Prognosis
;
Retrospective Studies
10.NPM1 High Mutant Allele Burden is an Adverse Prognostic Factor for AML Patients with Mutated NPM1.
Jiang-Xue HOU ; Shu-Juan WANG ; Yan-Fang LIU ; Qian-Qian HAO ; Chong WANG ; Tao LI ; Jun-Jun BAI ; Lin-Xiao LIAO ; Cheng-Yu GUO ; Yin-Yin CHANG ; Meng WANG ; Hui SUN ; Xin-Sheng XIE ; Zhong-Xing JIANG
Journal of Experimental Hematology 2019;27(2):365-372
OBJECTIVE:
To investigate the clinical features, accompanying gene mutation characteristics and prognostic factors of adult patients with acute myeloid leukemia with mutated NPM1 (NPM1AML).
METHODS:
Seventy-three patients with newly diagnosed adult NPM1AML were selected. The mutations of 22 genes were detected by second generation sequencing and 43 fusion genes of AML were detected by real-time fluorescent quantitative PCR. The Kaplan-Meier survival curve and Cox multivariate regression analysis were used to study the prognostic factors.
RESULTS:
A total of 74 NPM1 site mutations were detected in 73 patients with NPM1AML. The incidence rates were 92.0% L287fs, 2.7% Q289fs and W288fs, 1.4% L258fs and Q289H, among which 1 patient had 2 NPM1 mutations; the different mutation sites had no effect on the prognosis of NPM1AML. The median value of NPM1 variant allele frequency (VAF) was 35.4% (1.8%-56.6%). Based on the uppermost quartile of 38.4%, the patients were classified as NPM1 VAF>38.4% (NPM1AML) and NPM1 VAF≤38.4% (NPM1AML). Compared with NPM1AML, the early mortality rate was statistically significantly higher (33.3% vs 7.3%, P<0.05), and median EFS (148 d,95%CI 58-238 d vs 372 d,95%CI 264-480 d) (P<0.01) and median OS (179 d 95%CI 6-352 d vs 444 d) (P<0.01) were significantly shorter in NPM1 AML. A total of 126 accompanying gene mutation sites were detected in 87.7% of patients with NPM1AML. The patients with NRAS gene mutation displayed a higher rate of complete remission (100% vs 58%) (P<0.05) and longer median OS (not reached to 320 d, 95%CI 150-490 d) (P<0.05). The 43 fusion genes were examined in 65 out of 73 cases of NPM1AML, and in all the patients the fusion gene test was negative. Multivariate analysis showed that NPM1 VAF>38.4% was an independent prognostic factor for EFS (HR=3.1, 95% CI 1.6-6.4, P<0.01) and OS (HR=3.0, 95% CI 1.4-6.2, P<0.01).
CONCLUSION
The NPM1 gene mutation in AML patients often is accompanied by other gene mutations, while the coexistence of fusion genes is rare; high NPM1 mutant allele burden is an independent prognostic factor for adult AML patients with mutated NPM1.
Alleles
;
Humans
;
Leukemia, Myeloid, Acute
;
genetics
;
Mutation
;
Nuclear Proteins
;
genetics
;
Prognosis
;
fms-Like Tyrosine Kinase 3

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