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1.
Psychol Sci ; : 9567976241246561, 2024 May 09.
Artigo em Inglês | MEDLINE | ID: mdl-38722666

RESUMO

Confidence is an adaptive computation when environmental feedback is absent, yet there is little consensus regarding how perceptual confidence is computed in the brain. Difficulty arises because confidence correlates with other factors, such as accuracy, response time (RT), or evidence quality. We investigated whether neural signatures of evidence accumulation during a perceptual choice predict subjective confidence independently of these factors. Using motion stimuli, a central-parietal positive-going electroencephalogram component (CPP) behaves as an accumulating decision variable that predicts evidence quality, RT, accuracy, and confidence (Experiment 1, N = 25 adults). When we psychophysically varied confidence while holding accuracy constant (Experiment 2, N = 25 adults), the CPP still predicted confidence. Statistically controlling for RT, accuracy, and evidence quality (Experiment 3, N = 24 adults), the CPP still explained unique variance in confidence. The results indicate that a predecision neural signature of evidence accumulation, the CPP, encodes subjective perceptual confidence in decision-making independent of task performance.

2.
Appl Environ Microbiol ; 88(2): e0178021, 2022 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-34788063

RESUMO

Adaptive laboratory evolution (ALE) is a powerful approach for improving phenotypes of microbial hosts. Evolved strains typically contain numerous mutations that can be revealed by whole-genome sequencing. However, determining the contribution of specific mutations to new phenotypes is typically challenging and laborious. This task is complicated by factors such as the mutation type, the genomic context, and the interplay between different mutations. Here, a novel approach was developed to identify the significance of mutations in strains evolved from Acinetobacter baylyi ADP1. This method, termed rapid advantageous mutation screening and selection (RAMSES), was used to analyze mutants that emerged from stepwise adaptation to and consumption of high levels of ferulate, a common lignin-derived aromatic compound. After whole-genome sequence analysis, RAMSES allowed rapid determination of effective mutations and seamless introduction of the beneficial mutations into the chromosomes of new strains with different genetic backgrounds. This simple approach to reverse engineering exploits the natural competence and high recombination efficiency of ADP1. Mutated DNA, added directly to growing cells, replaces homologous chromosomal regions to generate transformants that will become enriched if there is a selective benefit. Thus, advantageous mutations can be rapidly identified. Here, the growth advantage of transformants under selective pressure revealed key mutations in genes related to aromatic transport, including hcaE, hcaK, and vanK, and a gene, ACIAD0482, which is associated with lipopolysaccharide synthesis. This study provided insights into the enhanced utilization of industrially relevant aromatic substrates and demonstrated the use of A. baylyi ADP1 as a convenient platform for strain development and evolution studies. IMPORTANCE Microbial conversion of lignin-enriched streams is a promising approach for lignin valorization. However, the lignin-derived aromatic compounds are toxic to cells at relevant concentrations. Although adaptive laboratory evolution (ALE) is a powerful approach to develop more tolerant strains, it is typically laborious to identify the mechanisms underlying phenotypic improvement. We employed Acinetobacter baylyi ADP1, an aromatic-compound-degrading strain that may be useful for biotechnology. The natural competence and high recombination efficiency of this strain can be exploited for critical applications, such as the breakdown of lignin and plastics and abundant polymers composed of aromatic subunits. The natural transformability of this bacterium enabled us to develop a novel approach for rapid screening of advantageous mutations from ALE-derived, aromatic-tolerant, ADP1-derived strains. We clarified the mechanisms and genetic targets for improved tolerance toward common lignin-derived aromatic compounds. This study facilitates metabolic engineering for lignin valorization.


Assuntos
Acinetobacter , Acinetobacter/metabolismo , Lignina/metabolismo , Engenharia Metabólica , Mutação
3.
Metab Eng ; 62: 260-274, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32979486

RESUMO

Microbial terephthalic acid (TPA) catabolic pathways are conserved among the few bacteria known to turnover this xenobiotic aromatic compound. However, to date there are few reported cases in which this pathway has been successfully expressed in heterologous hosts to impart efficient utilization of TPA as a sole carbon source. In this work, we aimed to engineer TPA conversion in Acinetobacter baylyi ADP1 via the heterologous expression of catabolic and transporter genes from a native TPA-utilizing bacterium. Specifically, we obtained ADP1-derived strains capable of growing on TPA as the sole carbon source using chromosomal insertion and targeted amplification of the tph catabolic operon from Comamonas sp. E6. Adaptive laboratory evolution was then used to improve growth on this substrate. TPA consumption rates of the evolved strains, which retained multiple copies of the tph genes, were ~0.2 g/L/h (or ~1 g TPA/g cells/h), similar to that of Comamonas sp. E6 and almost 2-fold higher than that of Rhodococcus jostii RHA1, another native TPA-utilizing strain. To evaluate TPA transport in the evolved ADP1 strains, we engineered a TPA biosensor consisting of the transcription factor TphR and a fluorescent reporter. In combination with whole-genome sequencing, the TPA biosensor revealed that transport of TPA was not mediated by the heterologous proteins from Comamonas sp. E6. Instead, the endogenous ADP1 muconate transporter MucK, a member of the major facilitator superfamily, was responsible for TPA transport in several evolved strains in which MucK variants were found to enhance TPA uptake. Furthermore, the IclR-type transcriptional regulator DcaS was identified as a repressor of mucK expression. Overall, this work presents an unexpected function of a native protein identified through gene amplification, adaptive laboratory evolution, and a combination of screening methods. This study also provides a TPA biosensor for application in ADP1 and identifies transporter variants for use in metabolic engineering applications focused on plastic upcycling of polyesters.


Assuntos
Técnicas Biossensoriais , Amplificação de Genes , Acinetobacter , Laboratórios , Ácidos Ftálicos , Rhodococcus
4.
J Child Adolesc Trauma ; 13(2): 153-161, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32549927

RESUMO

The potential for the development of psychopathology in aolescent refugees and asylees is high due to the trauma inherent in their experience. Yet, psychopathology rooted in trauma has proven amenable to treatment. Nonetheless, as most clinicians are monolingual, the language difference between clinician and client may be a barrier of desensitization and processing typically characteristic of trauma therapy. Thus, this study aimed to describe qualitative differences in speech production among native and non-native narratives using Linguistic Inquiry and Word Count (LIWC) processing software (Pennebaker et al. 2015) to understand if the current best practice will function similarly in these populations. We compared 10 adolescent immigrants (50% male) who narrated events that provoked their migration to the U.S. in their second language (L2; i.e., English) to 10 age- and gender-matched adolescents narrating in their first language (L1; i.e., Spanish). Results revealed L1 narratives were significantly higher in their use of/talk about anger, cognitive processes, discrepancy, tentativeness, perceptual processes, ingestion, relativity, time, work, and home. L2 narratives were higher in their use of/talk about positive emotions, death, causation, health, motion, space, and fillers. Findings have implications for the efficacy of treatments using discourse to ameliorate symptoms related to trauma in non-native languages.

5.
Nucleic Acids Res ; 48(9): 5169-5182, 2020 05 21.
Artigo em Inglês | MEDLINE | ID: mdl-32246719

RESUMO

One primary objective of synthetic biology is to improve the sustainability of chemical manufacturing. Naturally occurring biological systems can utilize a variety of carbon sources, including waste streams that pose challenges to traditional chemical processing, such as lignin biomass, providing opportunity for remediation and valorization of these materials. Success, however, depends on identifying micro-organisms that are both metabolically versatile and engineerable. Identifying organisms with this combination of traits has been a historic hindrance. Here, we leverage the facile genetics of the metabolically versatile bacterium Acinetobacter baylyi ADP1 to create easy and rapid molecular cloning workflows, including a Cas9-based single-step marker-less and scar-less genomic integration method. In addition, we create a promoter library, ribosomal binding site (RBS) variants and test an unprecedented number of rationally integrated bacterial chromosomal protein expression sites and variants. At last, we demonstrate the utility of these tools by examining ADP1's catabolic repression regulation, creating a strain with improved potential for lignin bioprocessing. Taken together, this work highlights ADP1 as an ideal host for a variety of sustainability and synthetic biology applications.


Assuntos
Acinetobacter/genética , Engenharia Metabólica , Acinetobacter/metabolismo , Clonagem Molecular/métodos , Genoma Bacteriano , Genômica , Lignina/metabolismo , Regiões Promotoras Genéticas , Ribossomos/metabolismo
6.
Environ Microbiol ; 20(8): 2686-2708, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29521452

RESUMO

Chemolithoautotrophic bacteria from the genera Hydrogenovibrio, Thiomicrorhabdus and Thiomicrospira are common, sometimes dominant, isolates from sulfidic habitats including hydrothermal vents, soda and salt lakes and marine sediments. Their genome sequences confirm their membership in a deeply branching clade of the Gammaproteobacteria. Several adaptations to heterogeneous habitats are apparent. Their genomes include large numbers of genes for sensing and responding to their environment (EAL- and GGDEF-domain proteins and methyl-accepting chemotaxis proteins) despite their small sizes (2.1-3.1 Mbp). An array of sulfur-oxidizing complexes are encoded, likely to facilitate these organisms' use of multiple forms of reduced sulfur as electron donors. Hydrogenase genes are present in some taxa, including group 1d and 2b hydrogenases in Hydrogenovibrio marinus and H. thermophilus MA2-6, acquired via horizontal gene transfer. In addition to high-affinity cbb3 cytochrome c oxidase, some also encode cytochrome bd-type quinol oxidase or ba3 -type cytochrome c oxidase, which could facilitate growth under different oxygen tensions, or maintain redox balance. Carboxysome operons are present in most, with genes downstream encoding transporters from four evolutionarily distinct families, which may act with the carboxysomes to form CO2 concentrating mechanisms. These adaptations to habitat variability likely contribute to the cosmopolitan distribution of these organisms.


Assuntos
Crescimento Quimioautotrófico , Genoma Bacteriano , Piscirickettsiaceae/genética , Ecossistema , Hidrogenase/genética , Filogenia , Piscirickettsiaceae/classificação , Piscirickettsiaceae/enzimologia , Piscirickettsiaceae/metabolismo , Enxofre/metabolismo
7.
Exp Hematol ; 42(2): 101-13.e5, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24184354

RESUMO

Cytoplasmic nucleophosmin (NPMc(+)) mutations and FMS-like tyrosine kinase 3 (FLT3) internal tandem duplication (ITD) mutations are two of the most common known molecular alterations in acute myeloid leukemia (AML); they frequently occur together, suggesting cooperative leukemogenesis. To explore the specific relationship between NPMc+ and FLT3/ITD in vivo, we crossed Flt3/ITD knock-in mice with transgenic NPMc+ mice. Mice with both mutations develop a transplantable leukemia of either myeloid or lymphoid lineage, definitively demonstrating cooperation between Flt3/ITD and NPMc+. In mice with myeloid leukemia, functionally significant loss of heterozygosity of the wild-type Flt3 allele is common, similar to what is observed in human FLT3/ITD+ AML, providing further in vivo evidence of the importance of loss of wild-type FLT3 in leukemic initiation and progression. Additionally, in vitro clonogenic assays reveal that the combination of Flt3/ITD and NPMc+ mutations causes a profound monocytic expansion, in excess of that seen with either mutation alone consistent with the predominance of myelomonocytic phenotype in human FLT3/ITD+/NPMc+ AML. This in vivo model of Flt3/ITD+/NPMc+ leukemia closely recapitulates human disease and will therefore serve as a tool for the investigation of the biology of this common disease entity.


Assuntos
Citoplasma/metabolismo , Leucemia Mieloide Aguda/genética , Mutação , Proteínas Nucleares/genética , Tirosina Quinase 3 Semelhante a fms/genética , Alelos , Animais , Duplicação Gênica , Perda de Heterozigosidade , Camundongos , Camundongos Transgênicos , Proteínas Nucleares/metabolismo , Nucleofosmina , Reação em Cadeia da Polimerase Via Transcriptase Reversa
8.
Mol Cancer Res ; 11(9): 1004-16, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23754844

RESUMO

UNLABELLED: Cure rates in pediatric acute leukemias remain suboptimal. Overexpression of the cell-surface chemokine receptor CXCR4 is associated with poor outcome in acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML). Certain nonchemotherapeutic agents have been shown to modulate CXCR4 expression and alter leukemia interactions with stromal cells in the bone marrow microenvironment. Because chemotherapy is the mainstay of AML treatment, it was hypothesized that standard cytotoxic chemotherapeutic agents induce dynamic changes in leukemia surface CXCR4 expression, and that chemotherapy-induced upregulation of CXCR4 represents a mechanism of acquired therapeutic resistance. Here, it was shown that cell lines variably upregulate CXCR4 with chemotherapy treatment. Those that showed upregulation were differentially protected from chemotherapy-induced apoptosis when cocultured with stroma. The functional effects of chemotherapy-induced CXCR4 upregulation in an AML cell line (MOLM-14, which harbors consistent upregulated CXCR4) and clinical specimens were explored. Importantly, enhanced stromal-cell derived factor-1α (SDF1A/CXCL12)-mediated chemotaxis and stromal protection from additional chemotherapy-induced apoptosis was found. Furthermore, treatment with plerixafor, a CXCR4 inhibitor, preferentially decreased stromal protection with higher chemotherapy-induced upregulation of surface CXCR4. Thus, increased chemokine receptor CXCR4 expression after treatment with conventional chemotherapy may represent a mechanism of therapeutic resistance in pediatric AML. IMPLICATIONS: CXCR4 may be a biomarker for the stratification and optimal treatment of patients using CXCR4 inhibitors.


Assuntos
Antineoplásicos/uso terapêutico , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/genética , Receptores CXCR4/genética , Antineoplásicos/metabolismo , Antineoplásicos/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/genética , Benzilaminas , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Quimiocina CXCL12/metabolismo , Quimiotaxia/efeitos dos fármacos , Quimiotaxia/genética , Criança , Ciclamos , Resistencia a Medicamentos Antineoplásicos , Regulação Leucêmica da Expressão Gênica , Compostos Heterocíclicos/uso terapêutico , Humanos , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/metabolismo , Receptores CXCR4/antagonistas & inibidores , Receptores CXCR4/metabolismo , Células Estromais/efeitos dos fármacos , Células Estromais/metabolismo , Regulação para Cima
9.
Br J Haematol ; 160(6): 785-97, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23294096

RESUMO

Infants with MLL-rearranged (MLL-R) acute lymphoblastic leukaemia (ALL) have a dismal prognosis. While most patients achieve remission, approximately half of patients recur with a short latency to relapse. This suggests that chemotherapy-resistant leukaemia stem cells (LSCs) survive and can recapitulate the leukaemia. We hypothesized that interactions between LSCs and the bone marrow microenvironment mediate survival and chemotherapy resistance in MLL-R ALL. Using primary samples of infant MLL-R ALL, we studied the influence of bone marrow stroma on apoptosis, proliferation, and cytotoxicity induced by the FLT3 inhibitor lestaurtinib. MLL-R ALL were differentially protected by stroma from spontaneous apoptosis compared to non-MLL-R ALL. Co-culture of bulk MLL-R ALL in direct contact with stroma or with stroma-produced soluble factors promoted proliferation and cell cycle entry. Stroma also protected bulk MLL-R ALL cells and MLL-R ALL LSCs from lestaurtinib-mediated cytotoxicity. Previous studies have demonstrated that CXCR4 mediates bone marrow microenvironment signalling. Using a xenograft model of MLL-R ALL, we demonstrated that CXCR4 inhibition with AMD3100 (plerixafor) led to markedly enhanced efficacy of lestaurtinib. Therefore, the bone marrow microenvironment is a mediator of chemotherapy resistance in MLL-R ALL and targeting leukaemia-stroma interactions with CXCR4 inhibitors may prove useful in this high-risk subtype of paediatric ALL.


Assuntos
Células da Medula Óssea/patologia , Comunicação Celular/fisiologia , Proteína de Leucina Linfoide-Mieloide/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Receptores CXCR4/antagonistas & inibidores , Células Estromais/patologia , Animais , Apoptose/genética , Processos de Crescimento Celular/genética , Linhagem Celular Tumoral , Técnicas de Cocultura , Histona-Lisina N-Metiltransferase , Humanos , Lactente , Camundongos , Camundongos Endogâmicos NOD , Camundongos SCID , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Prognóstico , Receptores CXCR4/genética , Receptores CXCR4/metabolismo , Análise de Sobrevida , Microambiente Tumoral , Ensaios Antitumorais Modelo de Xenoenxerto
11.
Blood ; 115(23): 4798-809, 2010 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-20215641

RESUMO

Cooperating leukemogenic events in MLL-rearranged (MLL-r) infant acute lymphoblastic leukemia (ALL) are largely unknown. We explored the role of promoter CpG island hypermethylation in the biology and therapeutic targeting of MLL-r infant ALL. The HELP (HpaII tiny fragment enrichment by ligation-mediated polymerase chain reaction [PCR]) assay was used to examine genome-wide methylation of a cohort of MLL-r infant leukemia samples (n = 5), other common childhood ALLs (n = 5), and normals (n = 5). Unsupervised analysis showed tight clustering of samples into their known biologic groups, indicating large differences in methylation patterns. Global hypermethylation was seen in the MLL-r cohort compared with both the normals and the others, with ratios of significantly (P < .001) hypermethylated to hypomethylated CpGs of 1.7 and 2.9, respectively. A subset of 7 differentially hypermethylated genes was assayed by quantitative reverse-transcription (qRT)-PCR, confirming relative silencing in 5 of 7. In cell line treatment assays with the DNA methyltransferase inhibitor (DNMTi) decitabine, MLL-r (but not MLL wild-type cell lines) showed dose- and time-dependent cytotoxicity and re-expression of 4 of the 5 silenced genes. Methylation-specific PCR (MSP) confirmed promoter hypermethylation at baseline, and a relative decrease in methylation after treatment. DNMTi may represent a novel molecularly targeted therapy for MLL-r infant ALL.


Assuntos
Azacitidina/análogos & derivados , Ilhas de CpG , Metilação de DNA/efeitos dos fármacos , Inibidores Enzimáticos/farmacologia , Proteína de Leucina Linfoide-Mieloide/biossíntese , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Regiões Promotoras Genéticas , Azacitidina/farmacologia , Azacitidina/uso terapêutico , Linhagem Celular Tumoral , Criança , Pré-Escolar , Estudos de Coortes , Metilação de DNA/genética , Metilases de Modificação do DNA/antagonistas & inibidores , Metilases de Modificação do DNA/metabolismo , Decitabina , Inibidores Enzimáticos/uso terapêutico , Feminino , Rearranjo Gênico/efeitos dos fármacos , Rearranjo Gênico/genética , Inativação Gênica/efeitos dos fármacos , Estudo de Associação Genômica Ampla , Histona-Lisina N-Metiltransferase , Humanos , Lactente , Masculino , Proteína de Leucina Linfoide-Mieloide/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras/enzimologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/genética
12.
Blood ; 113(26): 6691-4, 2009 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-19411627

RESUMO

Concordance of MLL-rearranged acute leukemia in infant monozygotic twins is thought to be 100% with a very short latency period, suggesting that either the MLL fusion itself is sufficient to cause leukemia or that it promotes the rapid acquisition of additional oncogenic events that result in overt disease. We report the first case of discordance in an infant monozygotic twin pair. Twin A presented at age 9 months with MLL-ENL(+) acute lymphoblastic leukemia and twin B remains healthy 3 years later. The presence and eventual clearance of a clonal population of MLL-ENL(+) cells was shown in the bone marrow and peripheral blood of twin B. Clearance of this clone was temporally associated with viral-induced cytopenias, suggesting an immune-mediated clearance of the clone before the development of leukemia. Thus, concordance of MLL-rearranged acute leukemia in infant monozygotic twins is not universal. The implications of this case for MLL-rearranged leukemogenesis are discussed.


Assuntos
Proteína de Leucina Linfoide-Mieloide/análise , Proteínas de Fusão Oncogênica/análise , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética , Pré-Leucemia/genética , Infecções Respiratórias/imunologia , Gêmeos Monozigóticos , Viroses/imunologia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais , Medula Óssea/patologia , Células Clonais/metabolismo , Células Clonais/patologia , Terapia Combinada , Humanos , Hibridização in Situ Fluorescente , Lactente , Masculino , Proteína de Leucina Linfoide-Mieloide/genética , Proteínas de Neoplasias/genética , Neutropenia/etiologia , Neutropenia/imunologia , Proteínas Nucleares/genética , Proteínas de Fusão Oncogênica/genética , Leucemia-Linfoma Linfoblástico de Células Precursoras B/tratamento farmacológico , Leucemia-Linfoma Linfoblástico de Células Precursoras B/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras B/radioterapia , Pré-Leucemia/complicações , Pré-Leucemia/imunologia , Pré-Leucemia/patologia , Indução de Remissão , Remissão Espontânea , Infecções Respiratórias/sangue , Infecções Respiratórias/complicações , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Trombocitopenia/etiologia , Trombocitopenia/imunologia , Fatores de Transcrição/genética , Viroses/sangue , Viroses/complicações
13.
Am J Public Health ; 98(4): 604-10, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18309133

RESUMO

Media agenda setting refers to the deliberate coverage of topics or events with the goal of influencing public opinion and public policy. We conducted a quantitative content analysis of 4 prominent newspapers to examine how the media gathered and distributed news to shape public policy priorities during Hurricane Katrina. The media framed most Hurricane Katrina stories by emphasizing government response and less often addressing individuals' and communities' level of preparedness or responsibility. Hence, more articles covered response and recovery than mitigation and preparation. The newspapers studied focused significantly more on government response than on key public health roles in disaster management. We discuss specific implications for public health professionals, policymakers, and mass media so that, in the future, coordination can be enhanced among these entities before, during, and after disasters occur.


Assuntos
Defesa Civil , Planejamento em Desastres , Desastres , Política de Saúde , Meios de Comunicação de Massa , Saúde Pública , Humanos , Política Pública , Socorro em Desastres
14.
Blood ; 110(3): 979-85, 2007 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-17440048

RESUMO

Frameshift mutations in exon 12 of the nucleophosmin gene (NPM1) result in aberrant cytoplasmic localization of the NPM protein (NPMc(+)) and occur in 25% to 35% of adult acute myeloid leukemia (AML). In adults with AML, NPMc(+) has been associated with normal karyotype, FLT3/ITD mutations, high remission induction rates, and improved survival (particularly in patients lacking FLT3/ITD). NPMc(+) has not been well characterized in childhood AML. This study examines the incidence and clinical significance of NPMc(+) in 295 children with newly diagnosed AML treated on a large cooperative group clinical trial (POG-9421). We find that NPMc(+) is relatively uncommon in childhood AML (23 of 295 patients, 8%); and is significantly associated with FLT3/ITD mutations (P = .046), female sex (P = .029), older age (P = .047), and normal cytogenetics (P < .001). There is a favorable impact of NPMc(+) on survival in children lacking FLT3/ITD (5-year EFS, 69% vs 35%; hazard ratio, 0.39; P = .051), which is similar in magnitude to the favorable impact of t(8;21) and inv(16). We conclude that NPMc(+) is relatively rare in childhood AML, particularly in younger children. NPMc(+) does not abrogate the negative prognostic influence of FLT3/ITD mutations, but may contribute to risk stratification in children who lack FLT3/ITD mutations by identifying a group with superior prognosis.


Assuntos
Mutação da Fase de Leitura , Leucemia Mieloide Aguda/genética , Proteínas Nucleares/genética , Tirosina Quinase 3 Semelhante a fms/genética , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Citoplasma/genética , Citoplasma/metabolismo , Intervalo Livre de Doença , Éxons/genética , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/mortalidade , Masculino , Proteínas Nucleares/metabolismo , Nucleofosmina , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida , Tirosina Quinase 3 Semelhante a fms/metabolismo
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