NPM1突变对IDH2突变急性髓系白血病患者的预后分析

Prognostic analysis of NPM1 mutation on IDH2-mutated acute myeloid leukemia patients

目的探讨核仁磷酸蛋白(NPM1)突变对异柠檬酸脱氢酶2(IDH2)突变急性髓系白血病(AML)患者的预后影响。方法选取蚌埠医学院第一附属医院血液内科2018年01月—2020年06月收治AML患者105例为研究对象。将AML患者分为IDH2突变阳性组(28例)和IDH2突变阴性组(77例)。比较两组患者化疗完全缓解率(CR)和2年生存率差异。结果AML患者IDH2突变阳性组CR率与IDH2突变阴性组患者比较,差异无统计学意义(P=0.113)。IDH2突变阳性组患者2年生存率、总体生存时间(OS)中位数与IDH2突变阴性组患者比较,差异无统计学意义(P=0.110)。105例患者中49例患者伴随NPM1突变,56例患者不伴随NPM1突变。伴随NPM1突变中IDH2突变阳性患者(13例)CR率、2年生存率、OS中位数与IDH2突变阴性患者(36例)比较,差异均无统计学意义(P>0.05);不伴随NPM1突变中IDH2突变阳性(15例)患者CR率、2年生存率、OS中位数与IDH2突变阴性患者(41例)比较,差异有统计学意义(P<0.05)。结论在AML不伴随NPM1突变的背景下,IDH2突变阳性患者的化疗疗效和2年生存率差于IDH2突变阴性患者。

Objective To investigate the effect of NPM1 mutation on the prognosis of IDH2-mutated acute myeloid leukemia patients.Methods A total of 105 AML patients admitted to the Department of Hematology of The First Affiliated Hospital of Bengbu Medical College from January 2018 to June 2020 were selected.AML patients were divided into IDH2 mutation positive group(28 cases)and IDH2 mutation negative group(77 cases).The differences in CR rate and 2-year survival rate were compared between the two groups.Results 1.Among the 105 AML patients,56 patients were not accompanied by NPM1 mutation,of which 15 cases were IDH2 mutation positive and 41 cases were IDH2 mutation negative.The CR rate was 33.3%(5/15)in 15 patients with positive IDH2 mutation and 70.7%(29/41)in 41 patients with negative IDH2 mutation.The difference between the two groups was statistically significant(P<0.05).2.The 2-year survival rate of 15 patients with positive IDH2 mutation was 40.0%(6/15)and the median OS was 17.00 months.The 2-year survival rate of 41 patients with negative IDH2 mutation was 70.7%(29/41),and the median OS was 24.00 months.There were significant differences in survival rate between the two groups(P<0.05).Conclusion Under the background that AML was not accompanied by NPM1 mutation,the chemotherapy efficacy and 2-year survival rate of patients with positive IDH2 mutation are worse than those with negative IDH2 mutation.