WT1和DNMT3A突变对急性髓性白血病预后的意义:一项 Meta 分析。

IF 2.4 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL
Shiyue Ma, Lingjian Tang, Hui Tang, Chaoli Wu, Xue Pu, Jun Yang, Ninhong Niu
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引用次数: 0

摘要

背景:成人急性白血病最常见的表现是急性髓性白血病(AML),这是一种高度异质性的血液系统恶性肿瘤。基因诊断技术的应用目前在许多临床领域都很普遍。根据最新研究,白血病细胞中存在的特定基因突变或重排是该病的主要病因。由于不同类型的白血病是由非典型突变基因引起的,因此检测这些突变或重排基因有助于诊断白血病,并确定该疾病的分子治疗靶点。方法使用 "WT1"、"DNMT3A"、"急性髓性白血病 "和 "生存 "等检索字段,分别查阅了 CBM、Cochrane Library、Scopus、EMBASE 和 PUBMED 数据库。在对相关文献进行方法评估的同时,还采用了 Cochrane 协作组织制定的偏倚风险评估方法。排除了具有以下特征的研究:(1) 不完整和重复的出版物,(2) 无法检索或转换数据,(3) 非英文或中文文章。结果:本次分析共纳入 13 项研究,涉及 3478 名受试者。Wilms' Tumor 1(WT1)突变频率为6.7%-35.73%,DNMT3A突变频率为12.06%-51.1%。有 WT1 突变的患者的缓解率低于无 WT1 突变的患者(OR = 0.22;95% 置信区间 [CI]:0.14,0.36;P < 0.00001;I2 = 55%)。DNMT3A突变对急性髓细胞白血病的预后没有统计学意义(OR = 1.21;95% CI:0.93, 1.58;P = 0.16;I2 = 80%)。剔除一项研究后,其他研究中 DNMT3A 突变指标(缓解率)的异质性显著降低(OR = 0.63; 95% CI: 0.43, 0.93; p = 0.02; I2 = 0%)。结论我们的荟萃分析表明,WT1突变会降低急性髓细胞白血病的缓解率。此外,DNMT3A 突变对 AML 的影响也需要谨慎对待。基因诊断对于急性髓细胞白血病的预后和临床治疗至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
WT1 And DNMT3A Mutations in Prognostic Significance of Acute Myeloid Leukemia: A Meta-Analysis.

Background: Adult acute leukemia most commonly manifests as acute myeloid leukemia (AML), a highly heterogeneous malignant tumor of the blood system. The application of genetic diagnostic technology is currently prevalent in numerous clinical sectors. According to recent research, the presence of specific gene mutations or rearrangements in leukemia cells is the primary cause of the disease. As different types of leukemia are caused by atypical mutated genes, testing for these mutations or rearrangements can help diagnose leukemia and identify the disease's molecular targets for treatment. Methods: Using the search fields "WT1," "DNMT3A," "Acute myeloid leukemia," and "survival," the CBM, Cochrane Library, Scopus, EMBASE, and PUBMED databases were separately reviewed. The methodology for evaluating the risk of bias developed by the Cochrane Collaboration was used in conjunction with a methodical evaluation of pertinent literature. Excluded studies with the following characteristics: (1) incomplete and repetitive publications, (2) unable to retrieve or convert data, (3) non-English or Chinese articles. Results: This analysis included 13 studies covering a total of 3478 subjects. The frequency of Wilms' Tumor 1 (WT1) mutations is 6.7%-35.73%, and the frequency of DNMT3A mutations is 12.06%-51.1%. The remission rate of patients with WT1 mutations was less than that of patients without WT1 mutations (OR = 0.22; 95% confidence interval [CI]: 0.14, 0.36; p < 0.00001; I2 = 55%). The DNMT3A mutation has no statistical significance for the prognosis of AML (OR = 1.21; 95% CI: 0.93, 1.58; p = 0.16; I2 = 80%). After removing one study, the heterogeneity of the indicator (mitigation rate) among other studies of DNMT3A mutation was dramatically reduced (OR = 0.63; 95% CI: 0.43, 0.93; p = 0.02; I2 = 0%). Conclusions: Our meta-analysis shows that WT1 mutations hurt the remission rate of AML. Moreover, the impact of DNMT3A mutations on AML needs to be treated with caution. Gene diagnosis is critical for the prognosis and clinical management of AML.

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来源期刊
CiteScore
7.80
自引率
2.90%
发文量
87
审稿时长
3 months
期刊介绍: Cancer Biotherapy and Radiopharmaceuticals is the established peer-reviewed journal, with over 25 years of cutting-edge content on innovative therapeutic investigations to ultimately improve cancer management. It is the only journal with the specific focus of cancer biotherapy and is inclusive of monoclonal antibodies, cytokine therapy, cancer gene therapy, cell-based therapies, and other forms of immunotherapies. The Journal includes extensive reporting on advancements in radioimmunotherapy, and the use of radiopharmaceuticals and radiolabeled peptides for the development of new cancer treatments.
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