实用医学杂志2023，Vol.39Issue(23)：3087-3092,6.DOI:10.3969/j.issn.1006-5725.2023.23.011
异基因造血干细胞移植治疗ASXL1基因突变的骨髓增生异常综合征患者的效果
Curative effect analysis of transplantation in patients with myelodysplastic syndrome with ASXL1 gene mutation
摘要
Abstract
Objective To investigate the efficacy and influencing factors of allo-HSCT in the treatment of MDS patients with ASXL1+.Methods The second-generation sequencing technique was used to detect 22 gene mutations in 247 newly diagnosed MDS patients in our hospital.The patients were divided into chemotherapy group and transplant group according to treatment style.The differences of OS and PFS between the two groups were compared,and the influencing factors of prognosis of transplant patients were analyzed.Results ASXL1+ was detected in 75 patients(30.36%),with a median mutation ratio of 42.93(18.10,58.39)%,10 received supportive treatment,43 received demethylation therapy or demethylation combined with pre-excitation therapy,and 22 received allo-HSCT.2-year PFS rate and OS rate of transplantation group were significantly higher than that of chemotherapy group(P<0.05).The 2-year OS rate in the low ASXL1 mutation load group(VAF≤42.93%)was significantly higher than that in the high ASXL1 mutation load group(VAF>42.93%)(P<0.05).In the context of allo-HSCT in patients with ASXL1+,2-year OS and PFS rates were significantly reduced in patients with RUNX1+ or ASXL1+(P<0.05);Multivariate analysis showed that high mutation load of ASXL1 or U2AF1+ were independent risk factors for OS in transplant patient(P<0.05).U2AF1+ were the risk factors for PFS(P<0.05).Conclusion allo-HSCT significantly improved the prognosis of patients with ASXL1+ MDS.High ASXL1 mutation load or U2AF1+ were independent risk factors affecting the outcome of allo-HSCT.关键词
骨髓增生异常综合征/异基因造血干细胞移植/ASXL1Key words
myelodysplastic syndrome/allogeneic hematopoietic stem cell transplantation/ASXL1分类
医药卫生引用本文复制引用
张玉培,谢新生,石雅洁,曹伟杰,郭荣,万鼎铭..异基因造血干细胞移植治疗ASXL1基因突变的骨髓增生异常综合征患者的效果[J].实用医学杂志,2023,39(23):3087-3092,6.基金项目
河南省科技攻关计划(编号:222102310262) （编号:222102310262）
