Journal of Shandong University (Health Sciences) ›› 2019, Vol. 57 ›› Issue (3): 42-48.doi: 10.6040/j.issn.1671-7554.0.2018.708

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Effect of gene mutation on the clinical efficacy of decitabine for patients with myelodysplastic syndrome

DOU Chunhui1, SHAO Jianhua1, DONG Xuebin1, ZHANG Ling2, CHEN Ping1, ZHAO Hongyu1, GU Linping1, SUN Lin1, XIE Jie1, WANG Min1, WANG Juan1, LI Na1, LI Fan1, LI Daqi1   

  1. 1. Department of Hematology, Jinan Central Hospital Affiliated to Shandong University, Jinan 250013, Shandong, China;
    2. Department of Gastroenterology, Yidu Central Hospital of Weifang, Qingzhou 262500, Shandong China
  • Published:2022-09-27

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Abstract: Objective To investigate the effect of gene mutation and related clinical indicators on the prognosis of patients with myelodysplastic syndromes(MDS). Methods Clinical data of 38 MDS patients were collected. Clinical specimens such as blood and genetic sequencing and karyotype analysis of bone marrow fluid were also collected. The response rate and survival rate of MDS patients treated with decitabine were statistically analyzed by single factor and multiple factors using SPSS software. The effects of clinical features and gene mutation on the prognosis of MDS patients treated with decitabine were retrospectively analyzed. Results Among the 38 cases, 92% of patients had at 山 东 大 学 学 报 (医 学 版)57卷3期 -窦春慧,等.骨髓增生异常综合征患者基因突变对地西他滨临床疗效的影响 \=-least one mutant gene and the detection rate of chromosome abnormality was 52.6%. Patients accepted monotherapy of decitabine or combined treatment with decitabine. The median number of treatment cycles was 4, and the total response rate was 63%(24/38). Fourteen patients were invalid. Multifactor analysis found that the response rate of patients with TET2 gene mutation was higher than those without mutation(82% vs 48%, Ps=0.043, Pm=0.034). The follow-up patients ended up with 12 deaths(32%). Median survival time of all patients was 27.6 months. Multifactor survival analysis found that chromosome karyotypes were good, intermediate and poor in 38 MDS patients and their survival time were 31.4, 17.6, 10.4 months, respectively. The risk stratification of IPSS were low risk, intermediate-1, intermediate-2, high risk and median survival time were 31.4, 27.6, 23.4, 11.4 months, respectively. Median survival time for patients with hemoglobin ≥100 g/L and <100 g/L were respective 31.4 and 19.4 months. Median survival time for patients with the number of cytopenias with 0-1 and greater than 2 were respective 31.4 and 17.6 months. The indicators mentioned above were statistically different(all P<0.05). Median survival time of patients with and without TP53 mutation were 16.4 and 31.4 months without statistical difference(P=0.097). Conclusion Patients with TET2 gene mutation have higher response rate to chemotherapy than those without mutation.

Key words: Myelodysplastic syndromes, Decitabine, Gene mutation, Prognosis

CLC Number: 

  • R551.3
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