Abstract
Acute myeloid leukemia (AML) is a rapidly fatal disease without the use of aggressive chemotherapy regimens. Cytogenetic and molecular studies are commonly used to classify types of AML based on prognosis, as well as to determine therapeutic regimens.
Although there are several AML classifications determined by particular translocations, cytogenetically normal AML represents a molecularly, as well as clinically, heterogeneous group of diseases. Laboratory evaluation of AML will become increasingly important as new mutations with both prognostic and therapeutic implications are being recognized. Moreover, because many patients with AML are being treated more effectively, these mutations may become increasingly useful as markers of minimal residual disease, which can be interpreted in an individualized approach.
Current laboratory studies of gene mutations in AML include analysis of NPM1, FLT3, CEBPA, and KIT. In addition to these genes, many other genes are emerging as potentially useful in determining patients' prognosis, therapy, and disease course.
This article briefly reviews the current most clinically relevant gene mutations and their clinical and immunophenotypic features, prognostic information, and methods used for detection.
摘要
如果不激进化疗,则急性髓系白血病是一种快速致死性疾病。细胞遗传学和分子生物学研究可以判断预后,因此广泛用于AML的分类,同时也可用于确定治疗方案。
尽管有些AML分类是根据特有的易位确定的,但细胞遗传学上AML通常代表分子生物学和临床表现具有异质性的一组疾病。因为逐渐认识到了一些具有预后判断和治疗意义的新突变,因此AML的实验室评估越来越重要。并且,因为患有AML的病人逐渐得到了有效地治疗,这些突变作为微小残留病变的标记可能逐渐变得有用,后者可以用于个体化治疗的解读。
现今有关AML基因突变的实验室研究包括NPM1、FLT3、CEBPA和KIT分析。除了这些基因以外,逐渐出现许多其他的基因,在确定病人预后、治疗和病程中具有潜在用途。
这篇文章简要总结目前与临床关系最密切的基因突变,以及这些突变具有的临床特点、免疫表型、预后信息和检测方法。
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