The Clinical Significance Of TP53 Deletion In Acute Leukemia Patients With Complex Chromosomal Abnormalities

Aim: To analyze the character of complex karyotype abnormal and the frequency of p53 gene deletion in patients of acute leukemia.The destination is to investigate the clinical significance of complex karyotype abnormal and p53 gene deletion in patients of acute leukemia. It may provide some experimental evidence of target therapy in patients of acute leukemia with complex karyotype abnormal.Methods: Fistly, to investigate the chromosome abnormalities of acute leukemia patiens by direct and cultivation method of conventional chromatosome in R banding , karyotype is named according to international nomenclature ISCN 2005.Then,we divided these patients into complex chromosome abnormalities(CCA) group and non-CCA group.I-FISH was used to analyze the percentage of p53 gene deletion in normal controls,CCA group and non-CCA group,to calculate the threshold of p53 gene deletion and the frequency of p53 gene deletion in the two group;through following the therapeutic efficacy and live time,to compare the difference of the deletion percentage of p53 gene,CR rate,median survival time in CCA group and non-CCA group,as well as in CCA group with p53 gene deletion and CCA group without p53 gene deletion .Results: (1).The character of complex karyotype abnormal: they often involve a number of adverse karyotype such as chromosome 17,chromosome 5,chromosome 7. Almost all of chromosomes can be involving, the reduction in the number of chromosome are more common than the increase;(2).the threshold of p53 gene deletion:the threshold of two green one red (2G1R) is 7%,the threshold of one green one red (1G1R) is 4.9%;(3).the percentage of p53 gene deletion in acute leukemia:the percentage of p53 gene deletion in the CCA group is 44.74% and in the non-CCA group it is 4.16%, the percentage of p53 gene deletion in 10 cases with chromosome 17 abnormal which are all CCA achieved 90%(p<0.001);(4)In 22 cases patients with non-CCA, the CR rate is 57.14% (12/21caes) and MST is 31 months;while The CR rate is11.76% (2/17caes) and MST is 67 days in 17 cases patients with CCA (p<0.0001);In 7 cases patients with p53 gene deletion in CCA pts, the CR rate is 14.28% (1/7caes) and MST is 67 days;In 10 cases patients without p53 gene deletion in CCA patients the CR rate is10.00% (1/10caes) and MST is 62 days (p>0.05).Conclusion:The CCA often involve a number of adverse karyotype;the percentage of p53 gene deletion in the CCA group was significantly higher than non-CCA group;The percentage of p53 gene deletion in patients with chromosome 17 abnormal is higher than CCA group.acute leukemia with CCA often has a lower CR rate and a short MST.The CR rate and MST hadn't significant between CCA patients with p53 gene deletion and without p53 gene deletion.