Molecular Biological Characteristics and Prognosis of Children with Acute Lymphoblastic Leukemia
Objective To analyze the molecular biological characteristics of children with acute lymphoblastic leukemia(ALL)and explore its influence on prognosis.Methods Clinical data of 104 newly diagnosed children with ALL in the Affiliated Hospital of Xuzhou Medical University from January 2017 to February 2021 were collected to analyze the detection of fusion genes and mutated genes and their effects on clinical characteristics and prognosis.Results There were 64males and 40 females.The median age at first visit was 5 years(3months to 14 years);B-ALL 95 cases,T-ALL 9 cases;there were 13deaths and 16 relapses.Among the 104 children,40 cases(38.5％)were detected with 9 fusion genes,including TEL-AML1,BCR-ABL1,MLL rearrangement,E2A-PBX1,SIL-TAL1,etc.SIL-TAL1 was found in T-ALL,and the other 8 fusion genes were found in B-ALL.Of the 96 children who underwent mutated gene detection,65 cases(67.7％)detected 33mutated genes,the high mutation rate was KRAS,NRAS,FLT3,IKZF1,TP53 and PAX5,and the high mutation rate was KRAS and NRAS in B-ALL.The high mutation rates of T-ALL were NOTCH 1 and FBWX7.The age of first diagnosis was younger in the MLL rearrangement group and older in the BCR-ABL1 positive group.MLL rearrangement,BCR-ABL1,NOTCH 1 mutation,IKZF1mutation positive group was prone to hyperleukaemia at first diagnosis,and BCR-ABL1 and NOTCH1 mutation positive group had high lactate dehydrogenase(LDH).Abnormal karyotypes were more common in children with posi-tive BCR-ABL1 and IKZF1 mutations.The 3-year overall survival(OS)rate and event-free survival(EFS)rate were low in children with MLL rearrangement,the 3-year OS rate was low in children with BCR-ABL1 positive,and the 3-year EFS rate was low in the IKZF1 mutant group.The failure of TEL-AML1 to turn negative after consolidation therapy was associated with recurrence in children with this subtype(P＜0.05).Conclusion Different molecular biological abnormalities have different effects on the clinical characteristics and prognosis of children with ALL.
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