FcyRⅡA gene polymorphism in acute myeloid leukemia patients with post-chemotherapy infection and the predictive value of serum CD64,HNL and PDW
OBJECTIVE To investigate the Fcγ receptor Ⅱ A(FcγRⅡ A)gene polymorphism in acute myeloid leu-kemia(AML)patients with post-chemotherapy infection and the predictive value of serum CD64,neutrophil apo-lipoprotein(HNL)and platelet distribution width(PDW).METHODS A total of 161 AML patients admitted to Qingdao Hospital of Traditional Chinese Medicine from Oct.2020 to Oct.2023 were selected and divided into in-fected group(62 cases)and uninfected group(99 cases)according to the infection status after chemotherapy.The pathogenic bacteria of post-chemotherapy infection in AML patients were analyzed.Serum levels of CD64,HNL and PDW were detected.The serum levels of CD64,HNL and PDW,as well as their diagnostic value of post-chemotherapy infections in AML patients,were compared between the two groups.FcγR Ⅱ a gene polymorphism in the two groups was detected by restriction fragment length polymorphism polymerase chain reaction(PCR-RFLP).RESULTS A total of 71 strains of pathogenic bacteria were co-cultured from AML patient with post-chem-otherapy infection,including 44 stains of gram-negative bacteria,21 strain s of gram-positive bacteria,and 6 strains of fungal,with Escherichia coli,Klebsiella pneumoniae,and Staphylococcus epidermidis predominating.The serum levels of CD64,HNL,and PDW in the infected group were(80.65±26.22)％ ,(90.52±30.16)ng/ml,and(12.39±4.10)％ ,respectively,higher than those in the uninfected group(P＜0.05).The area under the curve(AUC)of CD64,HNL,PDW and their combined detection for the diagnosis of post-chemotherapy infection in AML patients were 0.770,0.733,0.773 and 0.935,respectively.The AUC of the combined detection was high-er than that of single detection(P＜0.05).The frequencies of GG genotype and G allele at R131 locus of FcγR ⅡA gene in the infected group were 41.94％ and 62.10％ ,respectively,higher than those in the uninfected group,while the frequencies of AA genotype and A allele were 17.74％ and 37.90％ ,respectively,lower than those in the uninfected group(P＜0.05).CONCLUSIONS Post-chemotherapy infections in AML patients after chemotherapy were mostly gram-negative bacteria,and CD64,HNL and PDW were highly expressed after the occurrence of post-chemotherapy infections,and the combined detection of CD64,HNL and PDW was helpful in the diagnosis of post-chemotherapy infections in AML patients.The polymorphism of the FcγR Ⅱ A gene might be involved in the post-chemotherapy infections in AML patients.
Acute myeloid leukemiaChemotherapyInfectionPathogenic bacteriaFc-γ receptor ⅡANeutro-phil apolipoproteinPlatelet distribution widthGene polymorphismPredictive value
于巧、张静、姚姗姗、李彦
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青岛大学附属青岛市海慈医院(青岛市中医医院)血液科,山东青岛 266033
青岛大学附属青岛市海慈医院(青岛市中医医院)甲乳外科,山东青岛 266033
青岛大学附属青岛市海慈医院(青岛市中医医院)妇产科,山东青岛 266033
急性髓系白血病 化疗 感染 病原菌 Fcγ受体Ⅱ A 中性粒细胞载脂蛋白 血小板分布宽度 基因多态性 预测价值
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