低甲基化剂 (HMA) 在AML中显示出益处,而不是在基于表观遗传修饰 (EMM) 遗传突变的中间/高风险MDS中:从一个回顾性研究中得出:
Ruiqi Wang1,2, Yuanyuan Xu3, Bianhong Wang2
1Medicine School, Nankai University, 94 Weijin Road, Tianjin, 300071, China.
Annals of hematology
|November 5, 2023
概括
低甲基化剂 (HMAs) 在急性髓性白血病 (AML) 中显示出更好的治疗价值,而不是在骨髓质综合征 (MDS) 中,特别是在老年AML患者和具有特定遗传标记 (EMM+) 的患者中.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 药物基因组学 药物基因组学
背景情况:
- 血动剂 (HMA) 建议用于治疗急性髓性白血病 (AML) 和骨髓质综合征 (MDS).
- 在AML和中级/高风险MDS中HMAs的作用,考虑到基于下一代测序 (NGS) 的基因分析,需要进一步调查.
研究的目的:
- 在AML和中等/高风险MDS患者中,与非HMA疗法相比,对HMAs的预后影响进行回顾性分析.
- 评估表观遗传修饰剂甲基化 (EMM) 状态对HMAs治疗结果的影响.
主要方法:
- 对176名AML和128名中等/高风险MDS患者的回顾性分析.
- 用HMA和非HMA治疗方案治疗的患者之间的结局的比较.
- 分析按年龄,EMM状态,疾病阶段 (巩固,复发) 和治疗背景 (HSCT) 分层.
主要成果:
- 在AML中,HMA改善了老年患者和EMM (+) 患者的完全缓解率,并在复发病例中提高了存活率.
- 在EMM (+) AML队列中,HMA治疗是整体存活 (OS) 的独立预后因素.
- 在中级/高风险的MDS中,HMA在EMM (+) 中没有显示生存益处,并且与EMM (-) 患者的生存时间较短有关,而不是接受HSCT.
- 在HSCT之前先前的HMA治疗预测了MDS的不良预后,无论EMM状态如何.
结论:
- 与中级/高风险MDS相比,HMA在AML中具有更大的治疗价值,其结果受到EMM状态和患者年龄的影响.
- 这些发现表明,基于疾病类型和特定的分子形状,HMA的疗效差异.
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