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【Objective】 To investigate the expression level of liver kinase B1 (LKB1) gene in bone marrow of patients with acute non-lymphoblastic leukemia (AML) and its correlation with prognosis. 【Methods】 A total of 90 AML patients from May 2015 to January 2017 were selected as study subjects, and 30 cases of bone marrow specimens from non-malignant hematologic diseases were selected as control group. The expression of LKB1 mRNA in bone marrow was detected by real-time fluorescent quantitative PCR (qRT-PCR). The expression of LKB1 protein was detected by Western blot. The correlation between LKB1 mRNA and prognosis of AML was analyzed by Kaplan-Meier survival analysis. 【Results】 The mutation rate of LKB1 gene, the mRNA and LKB1 protein expression in bone marrow of AML patients was lower than those of control group (χ2=13.274, t=34.134, t=45.235, P<0.05). The mutation rate of LKB1 gene and the mRNA expression from high to low order is M1(81%, 17/21)>M5(78.6%, 11/14)>M6(75%, 3/4)>M2(42.4%, 14/33)>M4(41.7%, 5/12)>M3(35.3%, 6/17). Thefollow-up survival rate of patients with AML in the LKB1 high amplification group was higher than that of patients with LKB1 low amplification(χ2=8.039, P<0.05) The median survival time of the LKB1 high amplification group was higher than that of the LKB1low amplification group (27.3 months vs 19.8 months) (χ2=5.552, P<0.05). The incidence of post-chemotherapy infection, post-chemotherapy recurrence and extramedullary infiltration in the LKB1 high amplification group was lower than that in patients with LKB1 low amplification (P>0.05). 【Conclusion】 The expression level of LKB1 gene in patients with AML is low, moreover the more low expression level of LKB1 gene were, the more severe ill condition and more poor prognosis.
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Introducción: la validación de las alteraciones citogenéticas y moleculares presentes al diagnóstico constituyen los factores pronósticos más importantes de la leucemia aguda no linfoblástica y ha permitido establecer el riesgo individual, estratificar a los pacientes e individualizar su tratamiento. Objetivo: describir el comportamiento clínico y la evolución de pacientes con leucemia aguda no linfoblástica, no promielocítica, de novo, que recibieron tratamiento de inducción y consolidación clásico en el servicio de Hematología del Hospital Clínico Quirúrgico Hermanos Ameijeiras. Método: se realizó un estudio descriptivo, longitudinal y prospectivo que incluyó 23 pacientes ingresados entre mayo de 2008 y enero de 2011. Se estratificaron los pacientes en grupos de riesgo favorable, intermedio y desfavorable, teniendo en cuenta factores pronóstico clínicos, biológicos, citogenéticos y moleculares. Resultados: el 60,9 por ciento presentó recuento de leucocitos menor de 25 x 10(9)/L; el 47,8 por ciento tuvo la variante mielomonocítica, el 21,7 por ciento presentó cariotipo normal y el 10 por ciento la translocación (8;21). Las mutaciones del gen FLT3 y el gen NPM1 estuvieron presentes en 2 y 4 pacientes respectivamente. Con el tratamiento de inducción, el 84,2 por ciento alcanzó la remisión completa, predominaron los pacientes en el grupo de riesgo favorable sin diferencias significativas. En el grupo de riesgo molecular favorable el número de remisiones completas fue significativamente mayor (85,7 por ciento) (p = 0.05). El grupo de pacientes de riesgo favorable que se mantuvo en remisión completa con el tratamiento de consolidación representó el 54,5 por ciento, aunque no resultó significativo
Introduction: validation of cytogenetic and molecular abnormalities present at diagnosis is the most important prognostic factors of acute non-lymphoblastic leukemia. This has allowed us to establish the individual risk, stratify the patients and individualize their treatment. Objective: to describe the clinical behavior and outcome of patients with acute de novo non-lymphoblastic non-promyelocytic leukemia, receiving induction and classic consolidation therapy at the Department of Hematology of the Clinical Surgical Hospital Hermanos Ameijeiras. Methods: a descriptive, prospective longitudinal study was carried out with 23 patients admitted between May 2008 and January 2011. Patients were stratified into: favorable, intermediate, poor risk groups, according to biological, molecular and cytogenetics clinical prognostic factors. Results: 60.9 percent of patients had leukocyte counts less than 25 x 10(9)/L, 47.8 percent had myelomonocytic variant, 21.7 percent had normal karyotype and 10 percent had translocation (8; 21). Mutations of the genes FLT3 and NPM1 were present in 2 and 3 patients respectively. 84 percent of patients undergoing induction therapy achieved complete remission, predominantly the ones in the favorable risk group with no significant differences. In the favorable molecular risk group, the number of complete remissions was significantly higher (85.7 percent) (p=0.05). The group of favorable risk patients remaining in complete remission with the consolidation treatment had 54.5 percent, although it was not significant. Conclusions: the disease free survival was greater whereas overall survival rate was similar to the data reported in the international literature. Both were higher within the favorable risk group but without no significant difference, what is considered an important achievement of Cuban Healthcare System
Subject(s)
Humans , Leukemia, Myeloid, Acute/immunology , Leukemia, Myeloid, Acute/drug therapy , Consolidation Chemotherapy/methods , Induction Chemotherapy/methods , Disease-Free Survival , Epidemiology, Descriptive , Longitudinal Studies , Prospective Studies , Stratified SamplingABSTRACT
Background and Purpose:It has been proved that CD117 may be used as an immunology marker for diagnosis of leukemia of myeloid origin.The relationship between CD117 expression and effect of chemotherapy on the patients with Acute Nonlymphoblastic Leukemia(ANLL) remains unclear.This study is to investigate the relationship between CD117 expression and the response of patients with ANLL to chemotherapy.Methods:Flow cytometery(FCM) was used to detect the positive rate and the levels of CD117 expression of the bone marrow mononuclear cell(BMMNC) from 38 patients with acute lymphoblastic leukemia(ALL) and 81 patients with ANLL,respectively.All-trans Retinoic Acid(ATRA) was taken to treat M_(3) type of ANLL and protocol DA and/or HA was used to treat the other types.ANLL was divided into two groups: positive(+) and negative(-) expression of CD117.At the same time we compared the difference of rates of complete remission(CR) between CD117(+) and CD117(-) groups from ANLL after chemotherapy.Results:Positive percentage of expression of CD117 in ALL and ANLL groups were 13% and 70% respectively(P=0.000).Positive levels of CD117 decreased successively as follows: M_(3)/ M_(1)、M_(2)/ M_(6) / M_(4)、M_(5).CR rates of CD117(+) and CD117(-) groups of ANLL after chemotherapy were 51%(29/57) and 67%(16/24)(P=0.192),respectively.Conclusions:CD117 may serve as an immunology marker for the diagnosis of ANLL,but positive or negative expression of CD117 in ANLL was not associated with the response of the patients with ANLL to chemotherapy.
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Objective:To study expressions of CD117 and CD34 in the patients with acute promyelocytic leukemia(APL,M3) and in M1-M2 subtype from FAB classification for acute leukemia(AL).The focus of the study would be laid on the clinical significance of CD117/CD34 co-expression in the patients of M3 subtype.Methods:Researched cases of acute nonlymphoblastic leukemia(ANLL) were divided into two groups:M1-M2 subtype and M3 subtype.Flow cytometery(FCM) was used to detect the rates of positive expression of CD117 and CD34 on bone marrow mononuclear cell(BMMNC) in 54 patients of M3 and 63 patients of M1-M2 subtype respectively.Meanwhile,we compared the differences between the rates of expression of CD117 and CD 34.And,the rates of CD117/CD34 co-expression in patients of M1-M2 subtype and M3 subtype were studied.Results:Our results revealed that the positive rates of CD117 expression in M1-M2 subtype and M3 subtype were 71.4%(45/63) and 66.7%(36/54) respectively(P=0.58).The positive rates of CD34 expression in M1-M2 subtype and M3 subtype were 66.7%(42/63) and 11.1%(6/54) respectively(P=0.000).The positive rates of CD117/CD34 co-expression in M1-M2 subtype and M3 subtype were 71.1%(45/63) and 7.4%(4/54) respectively(P=0.000).Conclusion:CD117 may be used as immunology marker for leukemia of myeloid origin.CD34 had lower expression in M3 subtype than in M1-M2 subtype.The positive rate of CD117/CD34 co-expression in M3 subtype was significantly lower than that in M1-M2 subtype,which can help for diagnosis of M3 subtype and help differentiate M3 subtype from M1-M2 subtype as well.