DYNAMIC TESTING OF FUSION GENES IN CHILDHOOD ACUTE LYMPHOBLASTIC LEUKEMIA AND ITS SIGNIFICANCE
Objective To investigate the dynamic testing of fusion genes in the treatment of childhood acute lymphoblas tic leukemia (ALL) and its clinical significance.Methods A total of 168 children with ALL were enrolled in this study,inclu ding 84 fusion gene-negative children and 84 fusion gene-positive children,which consisted of 26 TEL-AML1-positive children,22EVI1-positive children,24 other fusion gene-positive children,and 12 dual fusion gene positive children.Gene amplification was used to detect the fusion gene expression before and after treatment to analyze the relationship between the fusion gene expression and the prognosis of ALL.The prognostic factors for ALL were analyzed by Cox proportional hazards regression model in fusion gene-positive incipient ALL children without sustained clearance.Results Being positive for fusion gene had no significant effect on overall survival (OS) rate (P ＞ 0.05) and had a significant effect on event-free survival (EFS) rate in ALL children (x2 =14.615,P ＜0.05).The TEL-AML1 positive ALL children had a significantly higher EFS rate than the fusion gene-negative ALL children and the other fusion gene-positive ALL children (x2 =6.877,3.926;P＜0.05).The ALL children with the sustained clea rance of TEL-AML 1 and other fusion genes had significantly higher 3-year EFS rates than the ALL children without the sustained clearance of TEL-AML1 and other fusion genes (x2 =8.925,6.091;P＜0.05).However,there was no significant difference in 3 year EFS rate between the ALL children with and without the sustained clearance of EVIl and dual fusion gene (P＞0.05).The clearance of fusion gene within the first year had no significant effect on 3-year EFS rate in ALL children (P＞0.05).The following factors could significantly decrease the 3-year EFS rate in the fusion gene-positive incipient ALL children without sustained clea rance:age over 10 years,T-cell ALL,high-risk ALL,and minimal residual disease (MRD) ≥10-2 on the 15th and 33th days of remission induction therapy (x2 =4.542-7.974,P ＜0.05).Multivariate analysis suggested that the prognostic factors were age over 10 years (95％CI=2.063-25.901,P＜0.05) and T-cell ALL (95％ CI=1.009-22.084,P＜0.05) in the fusion gene positive incipient ALL children without sustained clearance.Conclusion Dynamic testing of fusion genes is of great prognostic significance and is helpful for the individualized treatment of ALL patients.
NETL
NSTL
万方数据
维普
