Analysis of CD13 expression and mutations of FLT3-ITD and NPM1 in patients with acute myeloid leukemia

Zhou Chen; Li Dong; Zhang Fan; Qiao Chun; Huan Yahong; Song Yanzhi; Dong Ping; Xia Suqin; Wang Qiong; Li Cuiping; Zhang Sujiang; Li Jianyong; Lu Yinglian; Liao Haiying; Sui Xuemei

doi:10.13406/j.cnki.cyxb.000822

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Analysis of CD13 expression and mutations of FLT3-ITD and NPM1 in patients with acute myeloid leukemia

更新时间：2024-01-17

- Analysis of CD13 expression and mutations of FLT3-ITD and NPM1 in patients with acute myeloid leukemia
- Journal of Chongqing Medical University Vol. 41, Issue 4, Pages: 398-403(2016)
- 作者机构：
  
  1. 南京明基医院南京医科大学附属医院血液科
  2. 南京医科大学第一附属医院江苏省人民医院血液科
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.000822
  CLC： R733.71
- Published：2016，
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[1]周琛,李东,张凡,乔纯,环亚红,宋艳智,董平,夏素琴,王琼,李翠萍,张苏江,李建勇,卢应连,廖海英,隋雪梅.CD13表达及其与FLT3-ITD、NPM1突变在急性髓系白血病中的研究[J].重庆医科大学学报,2016,41(04):398-403.

Zhou Chen, Li Dong, Zhang Fan, et al. Analysis of CD13 expression and mutations of FLT3-ITD and NPM1 in patients with acute myeloid leukemia. [J]. Journal of Chongqing Medical University 41(4):398-403(2016)
[1]周琛,李东,张凡,乔纯,环亚红,宋艳智,董平,夏素琴,王琼,李翠萍,张苏江,李建勇,卢应连,廖海英,隋雪梅.CD13表达及其与FLT3-ITD、NPM1突变在急性髓系白血病中的研究[J].重庆医科大学学报,2016,41(04):398-403. DOI： 10.13406/j.cnki.cyxb.000822.

Zhou Chen, Li Dong, Zhang Fan, et al. Analysis of CD13 expression and mutations of FLT3-ITD and NPM1 in patients with acute myeloid leukemia. [J]. Journal of Chongqing Medical University 41(4):398-403(2016) DOI： 10.13406/j.cnki.cyxb.000822.

摘要

目的:探讨72例急性髓系白血病（acute myelogenous leukemia

AML）患者CD13表达及其与FLT3-ITD、NPM1突变同步检测的临床意义

并分析FLT3-ITD、NPM1突变的关系及其与CD13表达水平的相关性。方法:收集72例AML患者病例资料

采用流式细胞仪检测72例AML患者CD13表达

PCR及Sanger测序法检测FLT3-ITD、NPM1突变。结果:72例AML患者中68例CD13表达阳性（68/72

94.44%）

经诱导化疗

44例获得完全缓解（44/68

64.71%）。CD13

与CD13-患者相比

=2.118

P=0.148

完全缓解率差异无统计学意义（P

0.05）。68例CD13

的AML患者中

FLT3-ITD

/NPM1

双突变患者白细胞计数明显高于其余3组

差异均有统计学意义（P=0.000、P=0.010、P=0.000）

而完全缓解率明显低于FLT3-ITD

/NPM1

与FLT3-ITD

/NPM1

组

差异有统计学意义（χ

=8.400

P=0.000;χ

=8.880

P=0.000）。FLT3-ITD

/NPM1

患者中位生存期仅为24个月

较FLT3-ITD

/NPM1

与FLT3-ITD

/NPM1

患者

生存期更短。FLT3-ITD

/NPM1

患者的平均年龄、白细胞计数及血红蛋白均高于FLT3-ITD

/NPM1

患者（P=0.030;P=0.000;P=0.040）

白细胞计数及血红蛋白均高于FLT3-ITD

/NPM1

患者（P=0.020;P=0.00）

完全缓解为85.71%

明显高于FLT3-ITD

/NPM1

和FLT3-ITD

/NPM1

患者（χ2=8.40

P=0.000;χ2=13.45

P=0.000）

中位生存期为41个月（95%CI=34.4

7.6个月）

较FLT3-ITD

/NPM1

和FLT3-ITD

/NPM1

患者生存期长

提示NPM1突变患者预后良好。结论:68例CD13

患者中

FLT3-ITD

/NPM1

双突变患者具有高白细胞数和低CR率;FLT3-ITD

/NPM1

患者生存期短;FLT3-ITD

/NPM1

患者诱导缓解率高

FLT3-ITD

/NPM1

较低。对于AML患者

提示可以同时分析CD13表达及FLT3-ITD和NPM1突变的情况

为AML的相关治疗提供一个更好的思路。

Abstract

Objective:To explore the clinical implications of CD13 expression level and the mutation of FLT3-ITD and NPM1 gene in72 acute myeloid leukemia(AML)patients. Methods:Clinical features(blood routine and CR rate)of 72 AML patients were collected.The CD13 expression level was analyzed by flow cytometry and the mutations of FLT3-ITD and NPM1 were detected by polymerase chain reaction(PCR) as well as Sanger sequencing. Results:Totally 68(94.44%) out of 72 AML cases had CD13 expression in leukemia cells;44(64.71%)out of 72 AML cases had complete remission after induction chemotherapy. No statistical difference was found between CD13~+and CD13-patients(P >0.05). Among 68 CD13~+ AML patients

WBC count was higher in patients with FLT3-ITD~+/NPM1~+mutations than in other groups

with statistical differences(P=0.000;P=0.010;P=0.000)and CR rate was lower in patients with FLT3-ITD~+/NPM1~+mutations than in patients with FLT3-ITD~-/NPM1~+and FLT3-ITD~-/NPM1~- (χ2=8.400

P=0.000;χ2=8.88

P=0.000). The median overall survival of FLT3-ITD~+/NPM1~- patients was 24 months

shorter than that of FLT3-ITD~-/NPM1~+and FLT3-ITD~-/NPM1~- patients. FLT3-ITD~-/NPM1~+patients was older than FLT3-ITD~+/NPM1~- patients and had highe WBC and hemoglobin count(P =0.030;P =0.000;P =0.040). FLT3-ITD~-/NPM1 ~+ patients had higher WBC and hemoglobin coun than FLT3-ITD~-/NPM1~- patients(P=0.020;P=0.000). The CR rate was 85.71%

apparently higher than those of FLT3-ITD~+/NPM1 and FLT3-ITD~+/NPM1~- patients(χ2=8.400

P=0.000;χ2=13.450

P=0.000). The median overall survival was 41 months

longer tha those of FLT3-ITD~+/NPM1~+and FLT3-ITD~+/NPM1~- patients. All of these presented a favorable prognosis in FLT3-ITD~-/NPM1~+patients. Conclusion:In 68 CD13~+ patients

FLT3-ITD~+/NPM1~+ patients have higher WBC count and lower CR rate. FLT3-ITD~+/NPM1 patients have shorter survival. FLT3-ITD~-/NPM1~+patients have higher remission rate than FLT3-ITD~+/NPM1~- patients. Combinin detection of CD13 expression and the FLT-ITD/NPM1 mutations can make strong sense for AML cases.

关键词

CD13FLT3-ITD突变NPM1突变急性髓系白血病预后

Keywords

CD13FLT3-ITD mutationNPM1 mutationacute myelogenous leukemiaprognosis

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