BCR:ABL1阴性MPN和CML的顺序发生,反之亦然:来自现实世界队列的结果
Katrin Schweneker1, Miriam Lenk2, Wolfgang Kern2
1MLL Munich Leukemia Laboratory, Max-Lebsche-Platz 31, 81377, Munich, Germany. katrin.schweneker@mll.com.
International journal of hematology
|September 4, 2025
概括
慢性骨髓性白血病 (CML) 和BCR: ABL1- 阴性骨髓增殖性瘤 (MPNs) 可以顺序发展. 之前的MPN没有影响二次性CML的铁酶抑制剂治疗的有效性.
科学领域:
- 血液学
- 癌症学
- 分子生物学
背景情况:
- 慢性骨髓性白血病 (CML) 和BCR: ABL1- 阴性骨髓增殖性瘤 (MPN) 传统上被认为是相互排斥的疾病.
- 然而,最近的发现表明这些血液恶性瘤的同步或顺序发展的可能性.
研究的目的:
- 调查CML和BCR:ABL1阴性MPN的顺序发展.
- 分析顺序性CML和BCR: ABL1阴性MPN患者的特征和治疗结果.
主要方法:
- 对超过35,000名患者进行BCR:ABL1融合或JAK2,CALR或MPL突变的查.
- 对疾病的顺序发展和变异性等位基因频率 (VAF) 的分析.
- 在二次性CML中评估激素激酶抑制剂 (TKI) 的有效性.
主要成果:
- 5. 6% 的患者出现初级CML,随后出现BCR:: ABL1- 阴性MPN;5. 8% 的患者出现逆序列.
- 在患有二次性CML的患者中观察到较高的JAK2VAF.
- 之前的MPN没有影响二次性CML的TKI有效性;二次MPN的出现与JAK2 VAF或BCR:ABL1水平无关.
结论:
- 新发现的白细胞体或血小细胞体需要考虑二次MPN.
- 根据CML指南进行治疗时,二次CML不会对治疗反应产生负面影响.
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