伴有多种突变基因的初治原发AML的临床特征分析

Clinical features of de novo primary AML patients with multiple mutated genes

目的分析伴有多种突变基因的初治原发急性髓系白血病(AML)患者临床特征。方法回顾性分析2015年1月至2016年12月该院血液科144例初治原发AML住院患者的临床资料,男76例,女68例,中位年龄41.50岁,年龄四分位间距为25.25~53.75岁,依据"两类突变学说"的思路,把初治原发AML患者按基因突变数量(GMN)的不同分为GMN<2个(105例)和GMN≥2个(39例),比较各组临床特征的差异。结果两组年龄和外周血白细胞(WBC)比较,差异有统计学意义(P<0.05);FLT3-ITD、NRAS、WT1、CEBPA、NPM1、RUNX1、EP300、DNMT3A、IDH1、IDH2和TET2基因突变更常见于GMN≥2个(P<0.05)。结论伴有多种突变基因的初治原发AML老年人比例偏高,多伴有外周血高WBC,且不同功能突变基因共存。

Objective To investigate the clinical features of de novo primary acute myeloid leukemia （AML） patients with multiple mutated genes. Methods Clinical data of de novo primary AML patients in hospital from January 2015 to December 2016 were retrospectively reviewed, including 76 cases of male patients and 68 female patients, the median age was 41. 50 years old with inter-quartile range from 25.25 to 53.75 years ＇old. Based on the theory of ＂two kinds of mutation theory＂ ,all the patients were divided into the group with gene mutation number （GMN）〈2 （105 cases） and the group with GMN≥2 （39 cases）,and analyzed the types of clinical data. Results Comparing the age and peripheral serous white blood cell （WBC） between the two groups, there were statistically significant differences （P〈0. 05）;the group with GMN≥2 had a higher proportion of mutations in FLT3-ITD, NRAS, WT1, CEBPA, NPM1, RUNX1, EP300, DNMT3A, IDHI,IDH2 and TET2 （P〈0.05）. Conclusion The de novo primary AML patients,who have multiple mutated genes, have higher proportion in elder people with different functions often coexist. and higher peripheral serous WBC, and the mutated genes