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1.
Front Immunol ; 15: 1417398, 2024.
Article de Anglais | MEDLINE | ID: mdl-38966636

RÉSUMÉ

Introduction: Acute myeloid leukemia (AML) is an aggressive blood cancer with high heterogeneity and poor prognosis. Although the metabolic reprogramming of nicotinamide adenine dinucleotide (NAD) has been reported to play a pivotal role in the pathogenesis of acute myeloid leukemia (AML), the prognostic value of NAD metabolism and its correlation with the immune microenvironment in AML remains unclear. Methods: We utilized our large-scale RNA-seq data on 655 patients with AML and the NAD metabolism-related genes to establish a prognostic NAD metabolism score based on the sparse regression analysis. The signature was validated across three independent datasets including a total of 1,215 AML patients. ssGSEA and ESTIMATE algorithms were employed to dissect the tumor immune microenvironment. Ex vivo drug screening and in vitro experimental validation were performed to identify potential therapeutic approaches for the high-risk patients. In vitro knockdown and functional experiments were employed to investigate the role of SLC25A51, a mitochondrial NAD+ transporter gene implicated in the signature. Results: An 8-gene NAD metabolism signature (NADM8) was generated and demonstrated a robust prognostic value in more than 1,800 patients with AML. High NADM8 score could efficiently discriminate AML patients with adverse clinical characteristics and genetic lesions and serve as an independent factor predicting a poor prognosis. Immune microenvironment analysis revealed significant enrichment of distinct tumor-infiltrating immune cells and activation of immune checkpoints in patients with high NADM8 scores, acting as a potential biomarker for immune response evaluation in AML. Furthermore, ex vivo drug screening and in vitro experimental validation in a panel of 9 AML cell lines demonstrated that the patients with high NADM8 scores were more sensitive to the PI3K inhibitor, GDC-0914. Finally, functional experiments also substantiated the critical pathogenic role of the SLC25A51 in AML, which could be a promising therapeutic target. Conclusion: Our study demonstrated that NAD metabolism-related signature can facilitate risk stratification and prognosis prediction in AML and guide therapeutic decisions including both immunotherapy and targeted therapies.


Sujet(s)
Marqueurs biologiques tumoraux , Leucémie aigüe myéloïde , NAD , Microenvironnement tumoral , Humains , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/thérapie , Leucémie aigüe myéloïde/traitement médicamenteux , Leucémie aigüe myéloïde/immunologie , Pronostic , NAD/métabolisme , Microenvironnement tumoral/immunologie , Microenvironnement tumoral/génétique , Marqueurs biologiques tumoraux/génétique , Femelle , Mâle , Adulte d'âge moyen , Régulation de l'expression des gènes dans la leucémie , Analyse de profil d'expression de gènes , Transcriptome , Lignée cellulaire tumorale
3.
Int J Mol Sci ; 25(12)2024 Jun 08.
Article de Anglais | MEDLINE | ID: mdl-38928061

RÉSUMÉ

We review the importance of monocytic differentiation and differentiation induction in non-APL (acute promyelocytic leukemia) variants of acute myeloid leukemia (AML), a malignancy characterized by proliferation of immature myeloid cells. Even though the cellular differentiation block is a fundamental characteristic, the AML cells can show limited signs of differentiation. According to the French-American-British (FAB-M4/M5 subset) and the World Health Organization (WHO) 2016 classifications, monocytic differentiation is characterized by morphological signs and the expression of specific molecular markers involved in cellular communication and adhesion. Furthermore, monocytic FAB-M4/M5 patients are heterogeneous with regards to cytogenetic and molecular genetic abnormalities, and monocytic differentiation does not have any major prognostic impact for these patients when receiving conventional intensive cytotoxic therapy. In contrast, FAB-M4/M5 patients have decreased susceptibility to the Bcl-2 inhibitor venetoclax, and this seems to be due to common molecular characteristics involving mitochondrial regulation of the cellular metabolism and survival, including decreased dependency on Bcl-2 compared to other AML patients. Thus, the susceptibility to Bcl-2 inhibition does not only depend on general resistance/susceptibility mechanisms known from conventional AML therapy but also specific mechanisms involving the molecular target itself or the molecular context of the target. AML cell differentiation status is also associated with susceptibility to other targeted therapies (e.g., CDK2/4/6 and bromodomain inhibition), and differentiation induction seems to be a part of the antileukemic effect for several targeted anti-AML therapies. Differentiation-associated molecular mechanisms may thus become important in the future implementation of targeted therapies in human AML.


Sujet(s)
Différenciation cellulaire , Résistance aux médicaments antinéoplasiques , Leucémie aigüe myéloïde , Mitochondries , Monocytes , Humains , Leucémie aigüe myéloïde/métabolisme , Leucémie aigüe myéloïde/anatomopathologie , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/traitement médicamenteux , Leucémie aigüe myéloïde/génétique , Mitochondries/métabolisme , Monocytes/métabolisme , Monocytes/anatomopathologie , Résistance aux médicaments antinéoplasiques/génétique , Thérapie moléculaire ciblée , Antinéoplasiques/pharmacologie , Antinéoplasiques/usage thérapeutique
4.
J Proteomics ; 303: 105224, 2024 Jul 15.
Article de Anglais | MEDLINE | ID: mdl-38866132

RÉSUMÉ

Acute myeloid leukemia (AML) is an aggressive form of blood cancer and clinically highly heterogeneous characterized by the accumulation of clonally proliferative immature precursors of myeloid lineage leading to bone marrow failure. Although, the current diagnostic methods for AML consist of cytogenetic and molecular assessment, there is a need for new markers that can serve as useful candidates in diagnosis, prognosis and understanding the pathophysiology of the disease. This study involves the investigation of alterations in the bone marrow interstitial fluid and serum proteome of AML patients compared to controls using label-free quantitative proteomic approach. A total of 201 differentially abundant proteins were identified in AML BMIF, while in the case of serum 123 differentially abundant proteins were identified. The bioinformatics analysis performed using IPA revealed several altered pathways including FAK signalling, IL-12 signalling and production of macrophages etc. Verification experiments were performed in a fresh independent cohort of samples using MRM assays led to the identification of a panel of three proteins viz., PPBP, APOH, ENOA which were further validated in a new cohort of serum samples by ELISA. The three-protein panel could be helpful in the diagnosis, prognosis and understanding of the pathophysiology of AML in the future. BIOLOGICAL SIGNIFICANCE: Acute Myeloid Leukemia (AML) is a type haematological malignancy which constitute one third of total leukemias and it is the most common acute leukemia in adults. In the current clinical practice, the evaluation of diagnosis and progression of AML is largely based on morphologic, immunophenotypic, cytogenetic and molecular assessment. There is a need for new markers/signatures which can serve as useful candidates in diagnosis and prognosis. The present study aims to identify and validate candidate biosignature for AML which can be useful in diagnosis, prognosis and understand the pathophysiology of the disease. Here, we identified 201 altered proteins in AML BMIF and 123 in serum. Among these altered proteins, a set of three proteins viz., pro-platelet basic protein (CXCL7), enolase 1 (ENO1) and beta-2-glycoprotein 1 (APOH) were significantly increased in AML BMIF and serum suggest that this panel of proteins could help in future AML disease management and thereby improving the survival expectancy of AML patients.


Sujet(s)
Moelle osseuse , Liquide extracellulaire , Leucémie aigüe myéloïde , Protéome , Humains , Leucémie aigüe myéloïde/sang , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/métabolisme , Mâle , Protéome/analyse , Protéome/métabolisme , Femelle , Adulte d'âge moyen , Moelle osseuse/métabolisme , Moelle osseuse/anatomopathologie , Adulte , Liquide extracellulaire/métabolisme , Marqueurs biologiques tumoraux/sang , Protéines tumorales/sang , Protéines tumorales/métabolisme , Sujet âgé , Protéomique/méthodes
5.
In Vivo ; 38(4): 2016-2023, 2024.
Article de Anglais | MEDLINE | ID: mdl-38936913

RÉSUMÉ

BACKGROUND/AIM: Acute myeloid leukemia (AML) is a myeloproliferative neoplasm marked by abnormal clonal expansion of hematopoietic progenitor cells, displaying karyotypic aberrations and genetic mutations as prognostic indicators. The World Health Organization (WHO) and the European LeukemiaNet guidelines categorize BCR::ABL1 p190+ AML as high risk. This study explored the identification of the increased incidence of BCR::ABL1 p190+ in our AML population. PATIENTS AND METHODS: This study included 96 AML patients stratified according to WHO guidelines. Subsequently, patients were screened for genetic abnormalities, such as BCR::ABL1 p 190+, PML::RARA, RUNX1::RUNX1T1, and CBFB::MYH11 by quantitative reverse transcription polymerase chain reaction (RT-qPCR) analysis. RESULTS: Among 96 AML patients, 36 displayed BCR::ABL1 p190+, overcoming the expected global incidence. Age variations (19 to 78 years) showed no significant laboratory differences between BCR::ABL1 p190+ and non-BCR::ABL p190+ cases. The overall survival analysis revealed no statistically significant differences among the patients (p=0.786). CONCLUSION: The analyzed population presented a higher frequency of BCR::ABL1 p190+ detection in adult AML patients when compared to what is described in the worldwide literature. Therefore, more studies are needed to establish the reason why this incidence is higher and what the best treatment approach should be in these cases.


Sujet(s)
Protéines de fusion bcr-abl , Leucémie aigüe myéloïde , Humains , Adulte , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/mortalité , Adulte d'âge moyen , Mâle , Femelle , Protéines de fusion bcr-abl/génétique , Sujet âgé , Pronostic , Jeune adulte , Mutation
6.
Ann Hematol ; 103(7): 2337-2346, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38849603

RÉSUMÉ

High hyperdiploid karyotype with ≥ 49 chromosomes (which will be referred to as HHK) is rare in acute myeloid leukemia (AML). The European leukemia network (ELN) excluded those harboring only numerical changes (with ≥ 3 chromosome gains) from CK and listed them in the intermediate risk group, while the UK National Cancer Research Institute Adult Leukaemia Working Group classification defined ≥ 4 unrelated chromosome abnormalities as the cutoff for a poorer prognosis. Controversies occurred among studies on the clinical outcome of HHK AML, and their molecular characteristics remained unstudied. We identified 1.31% (133/10,131) HHK cases within our center, among which 48 cases only had numerical changes (NUM), 42 had ELN defined adverse abnormalities (ADV) and 43 had other structural abnormalities (STR). Our study demonstrated that: (1) No statistical significance for overall survival (OS) was observed among three cytogenetic subgroups (NUM, STR and ADV) and HHK AML should be assigned to the adverse cytogenetic risk group. (2) The OS was significantly worse in HHK AML with ≥ 51 chromosomes compared with those with 49-50 chromosomes. (3) The clinical characteristics were similar between NUM and STR group compared to ADV group. The former two groups had higher white blood cell counts and blasts, lower platelet counts, and mutations associated with signaling, while the ADV group exhibited older age, higher chromosome counts, higher percentage of myelodysplastic syndrome (MDS) history, and a dominant TP53 mutation.


Sujet(s)
Leucémie aigüe myéloïde , Mutation , Protéine p53 suppresseur de tumeur , Humains , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/mortalité , Leucémie aigüe myéloïde/diagnostic , Adulte d'âge moyen , Femelle , Mâle , Adulte , Sujet âgé , Protéine p53 suppresseur de tumeur/génétique , Chine/épidémiologie , Pronostic , Adolescent , Jeune adulte , Sujet âgé de 80 ans ou plus , Aberrations des chromosomes , Caryotype , Taux de survie , Caryotypage
7.
Int J Mol Sci ; 25(11)2024 May 26.
Article de Anglais | MEDLINE | ID: mdl-38891959

RÉSUMÉ

The tyrosine kinase domain of the FMS-Like tyrosine kinase 3 (FLT3-TKD) is recurrently mutated in acute myeloid leukemia (AML). Common molecular techniques used in its detection include PCR and capillary electrophoresis, Sanger sequencing and next-generation sequencing with recognized sensitivity limitations. This study aims to validate the use of droplet digital PCR (ddPCR) in the detection of measurable residual disease (MRD) involving the common FLT3-TKD mutations (D835Y, D835H, D835V, D835E). Twenty-two diagnostic samples, six donor controls, and a commercial D835Y positive control were tested using a commercial Bio-rad® ddPCR assay. All known variants were identified, and no false positives were detected in the wild-type control (100% specificity and sensitivity). The assays achieved a limit of detection suitable for MRD testing at 0.01% variant allelic fraction. Serial samples from seven intensively-treated patients with FLT3-TKD variants at diagnosis were tested. Five patients demonstrated clearance of FLT3-TKD clones, but two patients had FLT3-TKD persistence in the context of primary refractory disease. In conclusion, ddPCR is suitable for the detection and quantification of FLT3-TKD mutations in the MRD setting; however, the clinical significance and optimal management of MRD positivity require further exploration.


Sujet(s)
Leucémie aigüe myéloïde , Mutation , Maladie résiduelle , Réaction de polymérisation en chaîne , Tyrosine kinase-3 de type fms , Humains , Tyrosine kinase-3 de type fms/génétique , Maladie résiduelle/diagnostic , Maladie résiduelle/génétique , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Réaction de polymérisation en chaîne/méthodes , Femelle , Mâle , Adulte d'âge moyen , Sujet âgé , Adulte , Séquençage nucléotidique à haut débit/méthodes
8.
Cancer Med ; 13(11): e7376, 2024 Jun.
Article de Anglais | MEDLINE | ID: mdl-38864480

RÉSUMÉ

BACKGROUND: Acute myeloid leukemia (AML) is aggressive type of hematological malignancy. Its poses challenges in early diagnosis, necessitating the identification of an effective biomarker. This study aims to assess the diagnostic accuracy of long noncoding RNAs (lncRNA) in the diagnosis of AML through a meta-analysis. The study is registered on the PROSPERO website with the number 493518. METHOD: A literature search was conducted in the PubMed, Embase, Hinari, and the Scopus databases to identify relevant studies. We pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristics (ROC) using Stata 14.1 software. Heterogeneity between studies was determined through the I2 statistic and Cochran-Q test. A random effect model was chosen due to significant heterogeneity among included studies. Meta-regression and subgroup analysis were performed to assess the potential source of heterogeneity. Furthermore, potential publication bias was estimated using Deek's funnel plot asymmetry test. RESULTS: A total of 14 articles covering 19 studies were included in this meta-analysis comprising 1588 AML patients and 529 healthy participants. The overall pooled sensitivity, specificity, PLR, NLR, DOR, and the area under the summary ROC curve were 0.85 (95% CI = 0.78-0.91), 0.82 (95% CI = 0.72-0.89), 4.7 (95% CI = 2.9-7.4), 0.18 (95% CI = 0.12-0.28), 26 (95% CI = 12-53), and 0.90 (95% CI = 0.87-0.93), respectively. Moreover, lncRNAs from non-bone marrow mononuclear cells (BMMC) had superior diagnostic value with pooled sensitivity, specificity, and AUC were 0.93, 0.82, and 0.95, respectively. CONCLUSION: This meta-analysis demonstrated that circulating lncRNAs can serve as potential diagnostic markers for AML. High accuracy of diagnosis was observed in non-BMMC lncRNAs, given cutoff value, and the GADPH internal reference gene used. However, further studies with large sample size are required to confirm our results.


Sujet(s)
Marqueurs biologiques tumoraux , Leucémie aigüe myéloïde , ARN long non codant , Humains , ARN long non codant/génétique , ARN long non codant/sang , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/sang , Marqueurs biologiques tumoraux/génétique , Marqueurs biologiques tumoraux/sang , Courbe ROC , Sensibilité et spécificité
9.
J Med Case Rep ; 18(1): 269, 2024 Jun 05.
Article de Anglais | MEDLINE | ID: mdl-38835078

RÉSUMÉ

BACKGROUND: Acute myeloid leukemia (AML) is the second most common type of leukemia in children. Although prognostic and diagnostic tests of AML patients have improved, there is still a great demand for new reliable clinical biomarkers for AML. Read-through fusion transcripts (RTFTs) are complex transcripts of adjacent genes whose molecular mechanisms are poorly understood. This is the first report of the presence of the PPP1R1B::STARD3 fusion transcript in an AML patient. Here, we investigated the presence of PPP1R1B::STARD3 RTFT in a case of AML using paired-end RNA sequencing (RNA-seq). CASE PRESENTATION: A Persian 12-year-old male was admitted to Dr. Sheikh Hospital of Mashhad, Iran, in September 2019 with the following symptoms, including fever, convulsions, hemorrhage, and bone pain. The patient was diagnosed with AML (non-M3-FAB subtype) based on cell morphologies and immunophenotypical features. Chromosomal analysis using the G-banding technique revealed t (9;22) (q34;q13). CONCLUSIONS: Single-cell RNA sequencing (scRNA-seq) analysis suggested that the PPP1R1B promoter may be responsible for the PPP1R1B::STARD3 expression. Alterations in the level of lipid metabolites implicate cancer development, and this fusion can play a crucial role in the cholesterol movement in cancer cells. PPP1R1B::STARD3 may be considered a candidate for targeted therapies of the cholesterol metabolic and the PI3K/AKT signaling pathways involved in cancer development and progression.


Sujet(s)
Leucémie aigüe myéloïde , Humains , Mâle , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Enfant , Protein Phosphatase 1/génétique , Protéines de fusion oncogènes/génétique
10.
Rinsho Ketsueki ; 65(5): 343-352, 2024.
Article de Japonais | MEDLINE | ID: mdl-38825513

RÉSUMÉ

The blood cancer field has played a pioneering role in advancing precision medicine, with milestones such as development of ABL1 inhibitors for chronic myeloid leukemia. The significance of gene mutation information in AML treatment has increased, evident in classifications and guidelines from organizations such as WHO and ELN. This article examines the anticipated roles of cancer genome panels (CGPs) in AML treatment from three perspectives: diagnosis, risk stratification, and treatment selection. Use of CGPs enables more accurate diagnosis and risk stratification. In treatment selection, CGPs not only complements but also substitutes existing companion diagnostics, and is expected to be a crucial information source for future drug adoption and investigation of tumor-agnostic therapies. However, various challenges remain to be addressed, including the purpose and timing of CGPs, the time required for the tests, and how to utilize expert panels.


Sujet(s)
Leucémie aigüe myéloïde , Humains , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Mutation , Génome humain , Médecine de précision
11.
Nat Commun ; 15(1): 5014, 2024 Jun 12.
Article de Anglais | MEDLINE | ID: mdl-38866774

RÉSUMÉ

Genetic testing is crucial for precision cancer medicine. However, detecting multiple same-site insertions or deletions (indels) is challenging. Here, we introduce CoHIT (Cas12a-based One-for-all High-speed Isothermal Test), a one-pot CRISPR-based assay for indel detection. Leveraging an engineered AsCas12a protein variant with high mismatch tolerance and broad PAM scope, CoHIT can use a single crRNA to detect multiple NPM1 gene c.863_864 4-bp insertions in acute myeloid leukemia (AML). After optimizing multiple parameters, CoHIT achieves a detection limit of 0.01% and rapid results within 30 minutes, without wild-type cross-reactivity. It successfully identifies NPM1 mutations in 30 out of 108 AML patients and demonstrates potential in monitoring minimal residual disease (MRD) through continuous sample analysis from three patients. The CoHIT method is also competent for detecting indels of KIT, BRAF, and EGFR genes. Integration with lateral flow test strips and microfluidic chips highlights CoHIT's adaptability and multiplexing capability, promising significant advancements in clinical cancer diagnostics.


Sujet(s)
Systèmes CRISPR-Cas , Mutation de type INDEL , Leucémie aigüe myéloïde , Nucléophosmine , Humains , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/diagnostic , Maladie résiduelle/génétique , Maladie résiduelle/diagnostic , Protéines nucléaires/génétique , Protéines proto-oncogènes B-raf/génétique , Dépistage génétique/méthodes , Récepteurs ErbB/génétique , Protéines bactériennes , Endodeoxyribonucleases , Protéines associées aux CRISPR
12.
Medicine (Baltimore) ; 103(24): e38556, 2024 Jun 14.
Article de Anglais | MEDLINE | ID: mdl-38875377

RÉSUMÉ

This study aimed to assess hematological diseases next-generation sequencing (NGS) panel enhances the diagnosis and classification of myeloid neoplasms (MN) using the 5th edition of the WHO Classification of Hematolymphoid Tumors (WHO-HAEM5) and the International Consensus Classification (ICC) of Myeloid Tumors. A cohort of 112 patients diagnosed with MN according to the revised fourth edition of the WHO classification (WHO-HAEM4R) underwent testing with a 141-gene NGS panel for hematological diseases. Ancillary studies were also conducted, including bone marrow cytomorphology and routine cytogenetics. The cases were then reclassified according to WHO-HAEM5 and ICC to assess the practical impact of these 2 classifications. The mutation detection rates were 93% for acute myeloid leukemia (AML), 89% for myelodysplastic syndrome (MDS), 94% for myeloproliferative neoplasm (MPN), and 100% for myelodysplasia/myeloproliferative neoplasm (MDS/MPN) (WHO-HAEM4R). NGS provided subclassified information for 26 and 29 patients with WHO-HAEM5 and ICC, respectively. In MPN, NGS confirmed diagnoses in 16 cases by detecting JAK2, MPL, or CALR mutations, whereas 13 "triple-negative" MPN cases revealed at least 1 mutation. NGS panel testing for hematological diseases improves the diagnosis and classification of MN. When diagnosed with ICC, NGS produces more classification subtype information than WHO-HAEM5.


Sujet(s)
Séquençage nucléotidique à haut débit , Mutation , Syndromes myélodysplasiques , Syndromes myéloprolifératifs , Humains , Séquençage nucléotidique à haut débit/méthodes , Femelle , Mâle , Adulte d'âge moyen , Sujet âgé , Syndromes myéloprolifératifs/génétique , Syndromes myéloprolifératifs/diagnostic , Syndromes myéloprolifératifs/classification , Adulte , Syndromes myélodysplasiques/génétique , Syndromes myélodysplasiques/diagnostic , Syndromes myélodysplasiques/classification , Sujet âgé de 80 ans ou plus , Kinase Janus-2/génétique , Organisation mondiale de la santé , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/classification , Leucémie aigüe myéloïde/diagnostic , Récepteurs à la thrombopoïétine/génétique , Calréticuline/génétique , Jeune adulte
13.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 32(3): 693-701, 2024 Jun.
Article de Chinois | MEDLINE | ID: mdl-38926955

RÉSUMÉ

OBJECTIVE: To analyze the factors affecting overall survival (OS) of adult patients with core-binding factor acute myeloid leukemia (CBF-AML) and establish a prediction model. METHODS: A total of 216 newly diagnosed patients with CBF-AML in the First Affiliated Hospital of Zhengzhou University from May 2015 to July 2021 were retrospectively analyzed. The 216 CBF-AML patients were divided into the training and the validation cohort at 7∶3 ratio. The Cox regression model was used to analyze the clinical factors affecting OS. Stepwise regression was used to establish the optimal model and the nomogram. Receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to evaluate the model performance. RESULTS: Age(≥55 years old), peripheral blood blast(≥80%), fusion gene (AML1-ETO), KIT mutations were identified as independent adverse factors for OS. The area under the ROC curve at 3-year was 0.772 and 0.722 in the training cohort and validation cohort, respectively. The predicted value of the calibration curve is in good agreement with the measured value. DCA shows that this model performs better than a single factor. CONCLUSION: This prediction model is simple and feasible, and can effectively predict the OS of CBF-AML, and provide a basis for treatment decision.


Sujet(s)
Leucémie aigüe myéloïde , Humains , Leucémie aigüe myéloïde/diagnostic , Pronostic , Études rétrospectives , Adulte d'âge moyen , Femelle , Mâle , Mutation , Courbe ROC , Facteurs de transcription CBF/génétique , Nomogrammes , Adulte , Protéine-1 partenaire de translocation de RUNX1/génétique , Protéines proto-oncogènes c-kit/génétique , Modèles des risques proportionnels , Protéines de fusion oncogènes/génétique , Sous-unité alpha 2 du facteur CBF/génétique
14.
Front Immunol ; 15: 1252258, 2024.
Article de Anglais | MEDLINE | ID: mdl-38938565

RÉSUMÉ

This study discusses the importance of minimal residual disease (MRD) detection in acute myeloid leukemia (AML) patients using liquid biopsy and next-generation sequencing (NGS). AML prognosis is based on various factors, including genetic alterations. NGS has revealed the molecular complexity of AML and helped refine risk stratification and personalized therapies. The long-term survival rates for AML patients are low, and MRD assessment is crucial in predicting prognosis. Currently, the most common methods for MRD detection are flow cytometry and quantitative PCR, but NGS is being incorporated into clinical practice due to its ability to detect genomic aberrations in the majority of AML patients. Typically, bone marrow samples are used for MRD assessment, but using peripheral blood samples or liquid biopsies would be less invasive. Leukemia originates in the bone marrow, along with the cfDNA obtained from peripheral blood. This study aimed to assess the utility of cell-free DNA (cfDNA) from peripheral blood samples for MRD detection in AML patients. A cohort of 20 AML patients was analyzed using NGS, and a correlation between MRD assessment by cfDNA and circulating tumor cells (CTCs) in paired samples was observed. Furthermore, a higher tumor signal was detected in cfDNA compared to CTCs, indicating greater sensitivity. Challenges for the application of liquid biopsy in MRD assessment were discussed, including the selection of appropriate markers and the sensitivity of certain markers. This study emphasizes the potential of liquid biopsy using cfDNA for MRD detection in AML patients and highlights the need for further research in this area.


Sujet(s)
Séquençage nucléotidique à haut débit , Leucémie aigüe myéloïde , Maladie résiduelle , Cellules tumorales circulantes , Maladie résiduelle/diagnostic , Humains , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/sang , Cellules tumorales circulantes/anatomopathologie , Mâle , Femelle , Adulte d'âge moyen , Biopsie liquide/méthodes , Adulte , Marqueurs biologiques tumoraux/sang , Sujet âgé , Pronostic , Acides nucléiques acellulaires/sang
15.
R I Med J (2013) ; 107(7): 7-9, 2024 Jul 01.
Article de Anglais | MEDLINE | ID: mdl-38917306

RÉSUMÉ

Acute Myeloid Leukemia (AML) is a life-threatening illness that requires prompt diagnosis and often immediate treatment. It can present in a variety of manners but most commonly is associated with fevers, fatigue, shortness of breath, or infection. Extramedullary leukemia is a less common finding upon initial presentation, but includes dermatologic manifestations, including leukemia cutis, and rarely, large mass-like presentations known as myeloid sarcomas. While leukemic infiltration of organ systems is a well-described phenomenon, cardiac tamponade is a rare form of presentation. Herein we describe a 58-year-old man with a recent hospitalization for idiopathic cardiac tamponade who re-presented to the hospital with worsening dyspnea and fevers. He was found to have a recurrent pericardial effusion with features concerning for tamponade, as well as worsening thrombocytopenia and macrocytic anemia. Bone marrow biopsy revealed 24% myeloblasts, confirming the diagnosis of AML. Notably, his cardiac symptoms improved with treatment of his leukemia. To our knowledge, this is one of only a few cases of AML with cardiac tamponade as the initial presentation.


Sujet(s)
Tamponnade cardiaque , Leucémie aigüe myéloïde , Humains , Tamponnade cardiaque/étiologie , Mâle , Adulte d'âge moyen , Leucémie aigüe myéloïde/complications , Leucémie aigüe myéloïde/diagnostic , Épanchement péricardique/étiologie
16.
Ann Hematol ; 103(7): 2323-2335, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38722387

RÉSUMÉ

BACKGROUND: Acute myeloid leukemia (AML) patients with various nucleophosmin 1 (NPM1) mutations are controversial in the prognosis. This study aimed to investigate the prognosis of patients according to types of NPM1 mutations (NPM1mut). METHODS: Bone marrow samples of 528 patients newly diagnosed with AML, were collected for morphology, immunology, cytogenetics, and molecular biology examinations. Gene mutations were detected by next-generation sequencing (NGS) technology. RESULTS: About 25.2% of cases exhibited NPM1mut. 83.5% of cases were type A, while type B and D were respectively account for 2.3% and 3.0%. Furthermore, 15 cases of rare types were identified, of which 2 cases have not been reported. Clinical characteristics were similar between patients with A-type NPM1 mutations (NPM1A - type mut) and non-A-type NPM1 mutations (NPM1non - A-type mut). Event-free survival (EFS) was significantly different between patients with low NPM1non - A-type mut variant allele frequency (VAF) and low NPM1A - type mut VAF (median EFS = 3.9 vs. 8.5 months, P = 0.020). The median overall survival (OS) of the NPM1non - A-type mutFLT3-ITDmut group, the NPM1A - type mutFLT3-ITDmut group, the NPM1non - A-type mutFLT3-ITDwt group, and the NPM1A - type mutFLT3-ITDwt group were 3.9, 10.7, 17.3 and 18.8 months, while the median EFS of the corresponding groups was 1.4, 5.0, 7.6 and 9.2 months (P < 0.0001 and P = 0.004, respectively). CONCLUSIONS: No significant difference was observed in OS and EFS between patients with NPM1A - type mut and NPM1non - A-type mut. However, types of NPM1 mutations and the status of FLT3-ITD mutations may jointly have an impact on the prognosis of AML patients.


Sujet(s)
Leucémie aigüe myéloïde , Mutation , Protéines nucléaires , Nucléophosmine , Humains , Leucémie aigüe myéloïde/génétique , Leucémie aigüe myéloïde/mortalité , Leucémie aigüe myéloïde/diagnostic , Mâle , Adulte d'âge moyen , Femelle , Protéines nucléaires/génétique , Adulte , Sujet âgé , Adolescent , Pronostic , Sujet âgé de 80 ans ou plus , Jeune adulte , Taux de survie
17.
Leuk Lymphoma ; 65(6): 800-807, 2024 Jun.
Article de Anglais | MEDLINE | ID: mdl-38814858

RÉSUMÉ

Predictors for response to intensive therapy in AML have focused on baseline factors: percent leukemic blasts in marrow, cytogenetic/molecular genetic abnormalities, and presence of secondary AML. Non-baseline dynamic factors, occurring after induction but before response, may be useful for decisions related to salvage chemotherapy. We hypothesized white blood cell (WBC) count nadir after induction may be a real time indicator of treatment efficacy. We also examined whether time to stem cell transplant (SCT) or baseline molecular genetic abnormalities are associated with a low nadir. Data showed WBC nadir = 0 was a negative predictor for response to intensive induction and was correlated with reduced overall survival and progression free survival. Patients with WBC nadir = 0 did not have a significantly longer time to SCT, and none of the mutations increased the likelihood of reaching WBC nadir = 0. WBC nadir may be a useful real-time monitor in AML patients receiving intensive induction chemotherapy.


Sujet(s)
Protocoles de polychimiothérapie antinéoplasique , Leucémie aigüe myéloïde , Humains , Leucémie aigüe myéloïde/traitement médicamenteux , Leucémie aigüe myéloïde/thérapie , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/mortalité , Leucémie aigüe myéloïde/génétique , Numération des leucocytes , Adulte d'âge moyen , Mâle , Femelle , Pronostic , Adulte , Protocoles de polychimiothérapie antinéoplasique/usage thérapeutique , Protocoles de polychimiothérapie antinéoplasique/effets indésirables , Sujet âgé , Chimiothérapie d'induction/méthodes , Résultat thérapeutique , Jeune adulte , Transplantation de cellules souches hématopoïétiques/méthodes
18.
Cytopathology ; 35(4): 520-522, 2024 Jul.
Article de Anglais | MEDLINE | ID: mdl-38708952

RÉSUMÉ

The report describes a middle-aged woman with acute cholangitis combined with acute myeloid leukaemia, and examination suggesting that she was also a patient with a rare case of total visceral inversion. The analysis of this case helps clinicians to deepen the differential diagnosis of rare diseases and improve the timeliness and accuracy of diagnosis.


Sujet(s)
Angiocholite , Leucémie aigüe myéloïde , Humains , Angiocholite/anatomopathologie , Angiocholite/diagnostic , Leucémie aigüe myéloïde/anatomopathologie , Leucémie aigüe myéloïde/diagnostic , Leucémie aigüe myéloïde/complications , Femelle , Adulte d'âge moyen , Diagnostic différentiel , Maladie aigüe
20.
Front Immunol ; 15: 1321126, 2024.
Article de Anglais | MEDLINE | ID: mdl-38711501

RÉSUMÉ

Introduction: γδ T cells recognize and exert cytotoxicity against tumor cells. They are also considered potential immune cells for immunotherapy. Our previous study revealed that the altered expression of immune checkpoint T-cell immunoreceptor with immunoglobulin and ITIM domain (TIGIT) on γδ T cells may result in immunosuppression and is possibly associated with a poor overall survival in acute myeloid leukemia (AML). However, whether γδ T-cell memory subsets are predominantly involved and whether they have a relationship with clinical outcomes in patients with AML under the age of 65 remain unclear. Methods: In this study, we developed a multicolor flow cytometry-based assay to monitor the frequency and distribution of γδ T-cell subsets, including central memory γδ T cells (TCM γδ), effector memory γδ T cells (TEM γδ), and TEM expressing CD45RA (TEMRA γδ), in peripheral blood from 30 young (≤65 years old) patients with newly diagnosed non-acute promyelocytic leukemia (also known as M3) AML (AMLy-DN), 14 young patients with AML in complete remission (AMLy-CR), and 30 healthy individuals (HIs). Results: Compared with HIs, patients with AMLy-DN exhibited a significantly higher differentiation of γδ T cells, which was characterized by decreased TCM γδ cells and increased TEMRA γδ cells. A generally higher TIGIT expression was observed in γδ T cells and relative subsets in patients with AMLy-DN, which was partially recovered in patients with AMLy-CR. Furthermore, 17 paired bone marrow from patients with AMLy-DN contained higher percentages of γδ and TIGIT+ γδ T cells and a lower percentage of TCM γδ T cells. Multivariate logistic regression analyses revealed the association of high percentage of TIGIT+ TCM γδ T cells with an increased risk of poor induction chemotherapy response. Conclusions: In this study, we investigated the distribution of γδ T cells and their memory subsets in patients with non-M3 AML and suggested TIGIT+ TCM γδ T cells as potential predictive markers of induction chemotherapy response.


Sujet(s)
Récepteur lymphocytaire T antigène, gamma-delta , Récepteurs immunologiques , Humains , Récepteurs immunologiques/métabolisme , Mâle , Femelle , Adulte , Adulte d'âge moyen , Pronostic , Récepteur lymphocytaire T antigène, gamma-delta/métabolisme , Jeune adulte , Sujet âgé , Cellules T mémoire/immunologie , Cellules T mémoire/métabolisme , Sous-populations de lymphocytes T/immunologie , Sous-populations de lymphocytes T/métabolisme , Leucémie aigüe myéloïde/immunologie , Leucémie aigüe myéloïde/thérapie , Leucémie aigüe myéloïde/diagnostic , Mémoire immunologique , Leucémie aiguë promyélocytaire/immunologie , Leucémie aiguë promyélocytaire/diagnostic , Leucémie aiguë promyélocytaire/mortalité , Immunophénotypage
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