Clinical Analysis of Pediatric Acute Megakaryocytic Leukemia With CBFA2T3-GLIS2 Fusion Gene

被引:3
作者
Du, Yu [1 ]
Yang, Li [2 ]
Qi, Shanshan [2 ]
Chen, Zhi [1 ]
Sun, Ming [2 ]
Wu, Min [2 ]
Wu, Bin [1 ]
Tao, Fang [1 ]
Xiong, Hao [1 ,3 ]
机构
[1] Huazhong Univ Sci & Technol, Wuhan Childrens Hosp, Tongji Med Coll, Dept Hematol & Oncol, Wuhan, Hubei, Peoples R China
[2] Huazhong Univ Sci & Technol, Wuhan Childrens Hosp, Tongji Med Coll, Pediat Hematol Tumor Dis Lab, Wuhan, Hubei, Peoples R China
[3] Huazhong Univ Sci & Technol, Wuhan Childrens Hosp, Tongji Med Coll, Dept Hematol & Oncol, Wuhan 430016, Hubei, Peoples R China
关键词
acute megakaryocytic leukemia; transcriptome RNA sequencing; posttransplant cyclophosphamide; haploidentical hematopoietic stem cell transplantation; ACUTE MEGAKARYOBLASTIC LEUKEMIA; ACUTE MYELOID-LEUKEMIA; AML; OUTCOMES;
D O I
10.1097/MPH.0000000000002822
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
CBFA2T3-GLIS2 is the most frequent chimeric oncogene identified to date in non-Down syndrome acute megakaryocytic leukemia (AMKL), which is associated with extremely poor clinical outcome. The presence of this fusion gene is associated with resistance to high-intensity chemotherapy, including hematopoietic stem cell transplantation (HSCT), and a high cumulative incidence of relapse frequency. The clinical features and clinical effects of China Children's Leukemia Group-acute myeloid leukemia (AML) 2015/2019 regimens and haploidentical HSCT (haplo-HSCT) for treatment of 6 children harboring the CBFA2T3-GLIS2 fusion gene between January 2019 and December 2021 were retrospectively analyzed. The 6 patients included 4 boys and 2 girls with a median disease-onset age of 19.5 months (range: 6-67 mo) who were diagnosed with AMKL. Flow cytometry demonstrated CD41a, CD42b, and CD56 expression and lack of HLA-DR expression in all 6 patients. All the children were negative for common leukemia fusion genes by reverse transcription polymerase chain reaction, but positive for the CBFA2T3-GLIS2 fusion gene by next-generation sequencing and RNA sequencing. All patients received chemotherapy according to China Children's Leukemia Group-AML 2015/2019 regimens, and 4 achieved complete remission. Four children underwent haplo-HSCT with posttransplant cyclophosphamide-based conditioning; 3 had minimal residual disease negative (minimal residual disease <0.1%) confirmed by flow cytometry at the end of the follow-up, with the remaining patient experiencing relapse at 12 months after transplantation. Transcriptome RNA sequencing is required for the detection of the CBFA2T3-GLIS2 fusion gene and for proper risk-based allocation of pediatric patients with AML in future clinical strategies. Haplo-HSCT with posttransplant cyclophosphamide-based conditioning may improve survival in children with AMKL harboring the fusion gene.
引用
收藏
页码:96 / 103
页数:8
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