Analysis Of The Effect Of TET2 Mutation And SNP On Clinical Characteristics And Prognosis Of AML Patients

Objective1.To understand the incidence of TET2 mutation(TET2^mut)in adult acute myeloid leukemia?AML?and its effect on the clinical manifestations and prognosis of AML?non-M3?patients.2.To study the occurrence of TET2 SNP in AML,the clinical significance of TET2SNP rs2454206 in AML and its influence on the prognosis.3.To discuss the interrelationships between TET2^mut?TET2 SNP?TET2 SNP rs2454206 and CEBPa,NPM1,FLT3-ITD,ASXL1.Methods:From July 2015 to May 2018,a total of 124 adult patients with primary acute myeloid leukemia admitted to Yantai Yuhuangding Hospital and diagnosed by MICM typing were collected.A total of 24 genes including TET2,CEBPa,NPM1,FLT3-ITD and ASXL1 were detected by high-throughput sequencing.The clinical data and laboratory test results of 124 patients were collected and their clinical characteristics were analyzed,then follow up their curative effect,relapse rate and survival.Patients were grouped according to the results and statistically analyzed,to investigate the influence of TET2 gene on clinical characteristics and prognosis of patients.Results:1.Occurrence of TET2 mutation and its influence on clinical characteristics and prognosis of patients.A total of 25 TET2 gene mutations were detected in 124 AML?non-M3?patients,with a mutation rate of 20.2%.Compared with TET2 wild-type(TET2^wt)patients,TET2mutations are more common in elderly patients.The median age was 65 years in the TET2 mutant group and 56 years in the non-mutant group,the difference was statistically significant?P=0.008?.There was no significant difference in sex,blood count,percentage of marrow protocells,risk stratification,or response to treatment?P>0.05?.In the survival analysis,the overall survival?OS?rate of patients with TET2^mut was lower than that of patients with TET2^wt and the event free survival?EFS?rate was higher than TET2^wtt patients,but the difference was not statistically significant?P>0.05?.2.The incidence and clinical characteristics of AML patients with TET2 SNPTET2 single nucleotide polymorphisms?SNP?occurred in 75 cases,with an incidence of 60.5%,including 47 cases of SNP rs2454206?G>A?,with an incidence of37.9%.Statistics showed that TET2 SNP was more common in males,the differences were statistically significant?P=0.005?.Patients with TET2 SNP are more prone to hyperleukemia.In 124 adult patients with acute myeloid leukemia,the median of peripheral white blood cells in TET2 SNP patients was 13.4×10⁹/L,and the median of peripheral white blood cells in TET2 non-SNP patients was 6.41×10⁹/L,the difference was statistically significant?P=0.037?.However,in terms of age,peripheral blood hemoglobin,platelets,bone marrow primitive cells,risk stratification and therapeutic response,there was no significant difference between TET2 SNP patients and TET2non-SNP patients?P>0.05?.TET2 SNP rs2454206 had no significant correlation with gender and age?P>0.05?.However,the analysis found that the rate of 1 course of complete remission?74.5%?and the total complete rate?95.7%??CR?of patients with TET2^AG/GG were both obviously superior to those with TET2^AA?P<0.05?.In the univariate analysis,the 1-year OS rate and EFS rate of the patients with TET2^AA were significantly lower than those of the patients with TET2^AG/GG?P<0.05?.Multivariate analysis results:TET2^AA was an independent risk factor for the prognosis of OS and EFS in AML patients.3.Correlation analysis of TET2 gene and other AML related gene mutationsThe mutation frequency of KIT gene in TET2mut patients was 20%,and the mutation frequency of KIT gene in TET2wt patients was 6.1%?The mutation frequency of TP53 in TET2mut patients was 12%,which was higher than that in TET2wt patients,and the difference was statistically significant?P<0.05?.KIT mutation rate?4%?of TET2 SNP patients was lower than that of non-SNP patients?16.3%?,and the difference was statistically significant?P=0.025?.KIT mutation rate?2.1%?in TET2^AG/GGG/GG patients was lower than that in TET2^AA patients?13%?,and the difference was statistically significant?P=0.034?.Conclusion:In AML?non-M3?,TET2 mutation was more common in the elderly,but had no obvious influence on OS and EFS of AML patients.TET2 SNP is more common in male patients,more prone to high leukocyte.TET2 SNP rs2454206?G>A?is a common appear in acute myeloid leukemia and is associated with the better of response to chemotherapy and a better prognosis.