Blood:基因组变异情况可用于预测滤泡性淋巴瘤患者的预后

2018-11-17 MedSci MedSci原创

虽然最佳在分子遗传学方面的进展(如m7-FLIPI评分)提高了滤泡性淋巴瘤(FL)的风险分类,但对治疗的影响微乎其微。现研究人员对SWOG S0016试验所招募的255位FL患者在确诊时所进行的染色体基因组阵列检测(CGAT)所鉴定的拷贝数变异(CNAs)和拷贝中性杂合性缺失(cnLOH)的预后意义进行评估。主要评估基因组变异对早期进展(2年内进展或死亡)、无进展存活期(PFS)和总体存活率(OS

虽然最佳在分子遗传学方面的进展(如m7-FLIPI评分)提高了滤泡性淋巴瘤(FL)的风险分类,但对治疗的影响微乎其微。现研究人员对SWOG S0016试验所招募的255位FL患者在确诊时所进行的染色体基因组阵列检测(CGAT)所鉴定的拷贝数变异(CNAs)和拷贝中性杂合性缺失(cnLOH)的预后意义进行评估。主要评估基因组变异对早期进展(2年内进展或死亡)、无进展存活期(PFS)和总体存活率(OS)的影响。

研究发现基因组复杂性增加(变异总数)与FL预后不良相关。特定的染色体臂对临床预后至关重要。明确CNAs/cnLOH预后:早期进展与2p增益(p=0.007,OR=2.55[1.29-5.03])和2p cnLOH(p=0.01,HR=1.80[1.14,2.68])相关,包含VRK2和FANCL的2p增益可预测的PFS(p=0.01,HR=1.80[1.14-2.68])和OS(p=0.005,2.40[1.30-4.40]);CDKN2A/B(9p)缺失与PFS差相关(p=0.004,3.50[1.51,8.28]);而CREBBP(16p)和TP53(17p)缺失可预测OS不良(p<0.001,6.70[2.52,17.58]和p<0.001,3.90[1.85,8.31])。

m7-FLIPI研究的一个独立队列表明变异数量、TP53和CDKN2A/B缺失的预后意义均获得了深入证实。

总而言之,在FL确诊时,采用CGAT评估基因组变异可提高患者的风险分层,为靶向治疗的进一步发展提供支持。


原始出处:

Xiaoyu Qu,et al. Genomic alterations important for the prognosis in patients with follicular lymphoma treated on SWOG study S0016. Blood 2018 :blood-2018-07-865428; doi: https://doi.org/10.1182/blood-2018-07-865428

本文系梅斯医学(MedSci)原创编译,转载需授权!

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    2018-11-19 phoebeyan520

    学习了

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    2018-11-17 天地飞扬

    了解一下,谢谢分享!

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