TKI耐药慢性髓系白血病患者ABL激酶区点突变的相关因素分析

Analysis of related factors of point mutation in ABL kinase domain in patients with TKI-resistant chronic myeloid leukemia

目的探索酪氨酸激酶抑制剂(TKI)耐药慢性髓系白血病(CML)患者ABL激酶区点突变的相关因素。方法对2014年1月至2017年12月于重庆医科大学附属第一医院诊断为CML伴ABL激酶区点突变的18例耐药患者与19例不伴点突变的耐药患者的临床资料进行回顾性分析,应用单因素及多因素logistic回归分析探讨影响激酶区点突变的临床因素。结果单因素分析显示,复杂染色体核型、未规律治疗及Sokal积分中、高危是可能影响激酶区点突变的因素。多因素logistic回归分析显示,复杂染色体核型、未规律治疗及Sokal积分中、高危均是激酶区点突变的独立危险因素(P<0.05)。结论TKI耐药CML患者ABL激酶区点突变与多种临床因素相关,对这些因素进行早期预防、识别,有助于及时调整治疗方案,改善患者预后。

Objective To explore the related factors of point mutation in ABL kinase domain in patients with tyrosine kinase inhibitors(TKI)-resistant chronic myeloid leukemia chronic myeloid leukemia(CML).Methods The clinical data of 18 TKI-resistant CML patients with point mutations in ABL kinase domain and 19 TKT-resistant CML patients without point mutations diagnosed in the First Affiliated Hospital of Chongqing Medical University from January 2014 to December 2017 were collected and reviewed.Using univariate analysis and multivariate logistic regression analysis to discuss the clinical factors affecting the point mutation of the kinase domain.Results Univariate analysis showed that complex chromosome karyotypes,irregular treatment,and intermediate and high Sokal risk are the factors that may affect kinase domain mutations.Multivariate logistic regression analysis suggested that complex chromosome karyotypes,irregular treatment,and intermediate and high Sokal risk are all the independent risk factors of the kinase domain mutations(P<0.05).Conclusion Point mutation of ABL kinase domain in patients with TKI-resistant CML is associated with various clinical factors.Early prevention and identification of these factors can help adjust treatment plan in time,and improve the prognosis of patients.