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OBJECTIVE: To investigate the clinical significance of TP53 allelic state in patients with myelodysplastic syndromes (MDS). METHODS: The clinical data of 858 MDS patients who underwent second-generation sequencing (NGS) testing in the First Affiliated Hospital of Soochow University from January 2019 to December 2021 were retrospectively analyzed. RESULTS: The median age of the patients was 52 years old, and median follow-up time was 23.8 (0.4-109.6) months. Four hundred and one patients (46.7%) had at least one chromosomal abnormality, including 106 complex karyotypes and 78 monosomal karyotypes. A total of 103 cases of TP53 mutations were identified, with a mutation rate of 12%. Compared with TP53 wild-type, various types of chromosomal abnormalities were significantly more common in patients with TP53 mutations (all P < 0.001). Patients with TP53 mutations had lower hemoglobin levels, lower platelet counts and higher percentage of bone marrow primitive cell compared with TP53 wild type (all P < 0.05), and significantly shorter overall survival (OS). Among 97 evaluable patients, 33 cases (34%) were mono-allelic TP53 mutation, while 64 cases were bi-allelic TP53 mutation. Patients in bi-allelic TP53 mutation subgroup had a higher proportion of chromosomal abnormalities and a lower number of co-mutations compared with mono-allelic TP53 mutation. The median OS was 33.6 months in patients with mono-allelic state and only 11.4 months in patients with bi-allelic state (HR=2.138, 95%CI : 1.053-4.343, P >0.05). Median OS was not reached in TP53 wild-type patients, and there was a significant difference in OS among TP53 wild-type, mono-allelic and bi-allelic TP53 mutation patients (P < 0.001). Multivariable Cox regression analysis showed that bi-allelic TP53 was an independent predictor of poor outcomes (HR=2.808, 95%CI : 1.487-5.003, P =0.001), while mono-allelic TP53 mutation and wild-type TP53 were not. CONCLUSION: Patients with TP53 mutations have a poor prognosis, and bi-allelic TP53 mutations have a worse prognosis compared with mono-allelic TP53 mutations and independently affect the prognosis of MDS patients.
Assuntos
Alelos , Mutação , Síndromes Mielodisplásicas , Proteína Supressora de Tumor p53 , Humanos , Síndromes Mielodisplásicas/genética , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Proteína Supressora de Tumor p53/genética , Aberrações Cromossômicas , Masculino , FemininoRESUMO
INTRODUCTION: Myeloid tumors typically harbor TP53 mutations, which are linked to a dismal prognosis. There are fewer studies on whether TP53-mutated acute myeloid leukemia (AML) and myelodysplastic syndrome with excess blasts (MDS-EB) differ in molecular characteristics and should be considered as separate entities. METHODS: Between January 2016 and December 2021, a retrospective analysis was done on a total of 73 newly diagnosed AML patients and 61 MDS-EB patients from the first affiliated hospital of Soochow University. We described a survival profile and a thorough characterization of newly found TP53-mutant AML and MDS-EB and investigated the relationship between these characteristics and overall survival (OS). RESULTS: 38 (31.1%) were mono-allelic, and 84 (68.9%) were bi-allelic. There is no significant difference between TP53-mutated AML and MDS-EB (median OS 12.9 verse 14.4 months; p = .558). Better overall survival was linked to mono-allelic TP53 than bi-allelic TP53(HR = 3.030, CI:1.714-5.354, p < .001). However, the number of TP53 mutations and comutations were not significantly associated with OS. TP53 variant allele frequency cutoff of 50% is significant correlation with OS (HR: 2.177, 95% CI: 1.142-4.148; p = .0063). CONCLUSION: Our data revealed that allele status and allogeneic hematopoietic stem cell transplant independently affect the prognostic of AML and MDS-EB patients, with a concordance of molecular features and survival between these two disease entities. Our analysis favors considering TP53-mutated AML/MDS-EB as a distinct disorder.
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Leucemia Mieloide Aguda , Síndromes Mielodisplásicas , Humanos , Estudos Retrospectivos , Síndromes Mielodisplásicas/diagnóstico , Síndromes Mielodisplásicas/genética , Síndromes Mielodisplásicas/patologia , Leucemia Mieloide Aguda/diagnóstico , Leucemia Mieloide Aguda/genética , Prognóstico , Mutação , Proteína Supressora de Tumor p53/genéticaRESUMO
The vacancy-ordered double perovskite Cs2PdBr6 has the advantages of good optoelectronic properties, environmental friendliness, and high stability. It has been experimentally confirmed by researchers as an optoelectronic material with broad application prospects and research value, and is regarded as a potential substitute for lead halide perovskites. In this paper, based on the first-principles calculations in the framework of density functional theory, the crystal structure, elastic, electronic, and optical properties of Cs2PdBr6 under hydrostatic pressure of 0-6 GPa have been investigated with a step size of 0.5 GPa. The calculated results obtained under the condition of 0 GPa hydrostatic pressure are in good agreement with the existing experimental values. When the hydrostatic pressure is applied, the crystal structure parameters of Cs2PdBr6 appear nonlinear changes, but it can still maintain a stable cubic crystal structure. With the increase of pressure, the bulk modulus, shear modulus, and Young's modulus of Cs2PdBr6 increase gradually, and its ductility also improves gradually. Hydrostatic pressure can reduce the bandgap value of Cs2PdBr6, thereby enhancing the optoelectronic properties such as absorption and conductivity. In summary, hydrostatic pressure can change the bandgap value of Cs2PdBr6, improve its optoelectronic performance, and make it more suitable for use as the light-absorbing layer in solar cells.
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The mechanical, electronic structure and optical properties of aluminium based double halide perovskite were calculated by density functional theory. The formation energy and elastic constant confirm the stability of the cubic perovskite materials. The materials are all ductile and suitable for flexible photovoltaic and optoelectronic devices. The band gap values vary from 0.773 eV to 3.430 eV, exactly corresponding to the range of ideal band gap values for good photoresponse. The band structure analysis shows that all the materials possess small effective mass, which indicates a good transport of carriers. And these materials have a broad energy range of optical absorption for utilization and a detector of photons. Moreover, less expensive K2AgAlBr6 were investigated for comparison with materials containing a cesium element, and according to the results, is also a candidate for photoelectronic devices due to the similar properties.