发育阶段调节了RAS途径突变在接受Allo-HSCT治疗的AML患者的预后影响
Xiaolin Yuan1,2,3,4, Yibo Wu1,3,4, Yanan Wang1,3,4
1Bone Marrow Transplantation Center of The First Affiliated Hospital & Liangzhu Laboratory, Zhejiang University School of Medicine, Hangzhou, China.
RAS途径突变影响干细胞移植后急性髓性白血病 (AML) 的预后. 结果取决于AML的发育阶段,原始AML的复发率较低,单细胞AML的生存率较高.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 分子生物学分子生物学
背景情况:
- RAS路径突变和发育阶段影响白血病细胞行为.
- 它们对急性髓性白血病 (AML) 预后后异质造血干细胞移植 (allo-HSCT) 的综合影响尚不清楚.
研究的目的:
- 调查RAS途径突变和AML发育阶段对alo-HSCT后患者结局的影响.
- 澄清不同AML亚组中RAS途径突变的预后意义.
主要方法:
- 对364名成年AML患者进行了回顾性分析,这些患者接受了第一个与骨髓衰变条件的allo-HSCT.
- 检测RAS途径突变并评估复发的累积发病率 (CIR),整体存活率 (OS) 和无白血病存活率 (LFS).
主要成果:
- 在15.7%的患者中发现了RAS通路突变.
- 在原始的AML中,RAS突变与更高的CIR (38.6%对14.8%) 和增加复发风险 (HR=2.55) 相相关.
- 在单细胞AML中,RAS突变与较低的CIR (3.4%对26.8%) 和改善的LFS (93.1%对66.9%,HR=0.23) 相关.
结论:
- 在接受allo-HSCT的AML患者中,RAS途径突变的预后影响严重依赖于白血病的发育阶段.
- RAS突变可能预示着原始AML的预后会更差,但移植后单细胞AML的预后会更好.
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