73例慢性髓系白血病患者中IKAROS6表达研究

Analysis of IKAROS6 Expression in 73 Patients with Chronic Myelogenous Leukemia

本研究旨在探讨慢性髓系白血病(CML)患者IKARO S6表达情况及其临床意义。采用PCR扩增产物克隆测序法检测73例CML患者中IKARO S6表达情况,了解IKARO S6阳性患者的临床特征。结果表明,在8例健康对照标本中未检测到IKARO S6表达,在15例CML慢性期和加速期标本中也均未检测到IKARO S6表达,42例急淋变的CML标本中15例(35.71%)表达IKARO S6,16例发生急髓变的CML标本中均未检测到IKARO S6表达;在42例急淋变的CML标本中:IKARO S6表达阳性的患者完全缓解(CR)率为40%(6/15例),显著低于IKARO S6表达阴性组(85.19%,23/27例)(p<0.01);IKARO S6表达阳性的患者缓解后15个月内(2-18个月)复发率66.7%(4/6例),显著高于IKARO S6表达阴性组(21.74%,5/23例)(p<0.05)。结论:IKARO S基因异常表达可见于CML进展为急性淋巴细胞白血病的患者,并以IKARO S6异构体为主。IKARO S基因异常表达可能是CML急变为ALL的一个重要因素和独立的预后指标。

This study was aimed to evaluate IKAROS6 expression in patients with chronic myelogenous leukemia （CML） and its clinical significance, cDNAs from 73 CML patients were amplified by PCR and sequenced for IKAROS expression to elucidate clinical characteristics in IKAROS6 positive patients. The results showed that there was no IKAROS6 gene expression in 8 healthy controls and 15 CML patients in chronic phase and accelerated phase, and 15 cases （35.71% ） were 1KAROS6 positive in lymphoblast crisis samples among 42 newly diagnosed CML; however, none was found in myeloblast crisis of 16 newly diagnosed CML. Among 42 lymphoblast crisis of CML, the complete remission （CR） rate of IKAROS6 expression postive patients reached 40% （6/15）, which was obviously lower than that in IKAROS6 negative patients（85.19%, 23/27） （p 〈0.01 ）, IKAROS6 positive patients relapsed after CR for 15 （2 - 18） months with relapse rate 66.7% （4/6）, which was higher than that in expressed wild type 1KAROS gene patients （21.74%, 5/23） （p 〈 0.05 ）. It is concluded that abnormal expression of IKAROS gene dominated by IKAROS6 isoforms can be detected in lymphoblast crisis samples of CML patients. Abnormal expression of IKAROS gene may be an important factor in lymphoblast crisis of CML. Therefore, detection of 1KAROS gene expression may be important for target therapy and evaluation of clinical prognosis of CML patients.