CAJ | 학술논문

目的比较初治正常核型急性髓系白血病(NK-AML) FLT3-ITD基因伴随NPM1基因联合突变(FLT3-ITD+/NPM1+)与无NPM1突变(FLT3-ITD +/NPM1-)者的临床特征.方法回顾性分析FLT3-ITD+/NPM1+初治AML(非APL)20例和FLT3-ITD+/NPM1-初治AML(非APL)患者25例的临床资料;应用流式细胞术进行免疫表型分析,采用PCR扩增产物DNA测序法检测FLT3-ITD及NPM1的基因突变.结果 FLT3-ITD+/NPMI+组患者年龄、外周血PLT计数、骨髓原始细胞比例均高于FLT3-ITD+/NPM1-组患者(P＜0.05);其骨髓细胞表达CD34及CD117阳性细胞数均低于FLT3-ITD+/NPM1-组(P＜0.05),两组患者在性别比例、外周血WBC计数、HGB水平、第1疗程完全缓解率及随访6个月OS率上差异未见统计学意义(P＞0.05).结论高龄患者易发生FLT3-ITD伴随NPM1突变,其有较高的PLT计数和骨髓原始细胞比例,但是这些骨髓细胞表达CD34及CD117阳性细胞数偏低,FLT3-ITD伴随NPM1突变与否对患者短期预后无显著影响.
목적 비교초치정상핵형급성수계백혈병(NK-AML) FLT3-ITD기인반수NPM1기인연합돌변(FLT3-ITD+/NPM1+)여무NPM1돌변(FLT3-ITD +/NPM1-)자적림상특정.방법 회고성분석FLT3-ITD+/NPM1+초치AML(비APL)20례화FLT3-ITD+/NPM1-초치AML(비APL)환자25례적림상자료;응용류식세포술진행면역표형분석,채용PCR확증산물DNA측서법검측FLT3-ITD급NPM1적기인돌변.결과 FLT3-ITD+/NPMI+조환자년령、외주혈PLT계수、골수원시세포비례균고우FLT3-ITD+/NPM1-조환자(P＜0.05);기골수세포표체CD34급CD117양성세포수균저우FLT3-ITD+/NPM1-조(P＜0.05),량조환자재성별비례、외주혈WBC계수、HGB수평、제1료정완전완해솔급수방6개월OS솔상차이미견통계학의의(P＞0.05).결론 고령환자역발생FLT3-ITD반수NPM1돌변,기유교고적PLT계수화골수원시세포비례,단시저사골수세포표체CD34급CD117양성세포수편저,FLT3-ITD반수NPM1돌변여부대환자단기예후무현저영향.
Objective To compare the clinical characteristics of FLT3-ITD +/NPM1 + and FLT3-ITD +/NPM1-in newly diagnosed acute myeloid leukemia with normal karyotype.Methods The clinical data of 20 cases of FLT3-ITD +/NPM1 + and 25 cases of FLT3-ITD +/NPM1-were retrospectively analyzed.Immunophenotypes were analyzed by flow cytometry and the mutations of FLT3-ITD and NPM1 genes were detected by PCR-DNA sequencing.Results Patients with FLT3-ITD + and NPM1 + mutation were significantly older in age with higher PLT count and blast ratio in bone marrow in comparison to that of patients without NPM1 mutation(P ＜ 0.05).The positive rate of CD34 、CD117 cells were significantly lower in blasts from FLT3-ITD +/NPM1 + than these in blasts from FLT3-ITD +/NPM1-(P ＜ 0.05),whereas no significant differences were found in sex,WBC count,HGB level,the complete remission rate after the first cycle of induction chemotherapy and OS rate at six months in two groups (P ＞ 0.05).Conclusions FLT3-ITD and NPM1 mutations are common in the elders with higher platelet count and more blasts in bone marrow and these blasts express less CD34 and CD117.The short-term clinical responses of patients with FLT3-ITD mutation are not affected by NPM1 mustation.