Expression Of EVI1 Gene And Its Clinical Significance In Pediatric Acute Myeloid Leukemia

Background:Using a retrospective study,203 patients with AML were admitted to the Hematology and Tumor Center of Children’s Hospital of Chongqing Medical University from December 2012 to May 2017 and studied to detect the expression of EVI1 gene in children with acute myeloid leukemia（AML）,analyze the clinical features,therapeutic efficacy,survival,cell morphology,and fusion genes of EVI1-positive patients and compare them with EVI1-negative patients.Materials and Methods:203 children with acute myeloid leukemia were divided into EVI1 positive group（43 cases）and EVI1 negative group according to EVI expression.Multiple nested RT-PCR methods and real-time quantitative RQ-PCR were used to detect the expression of EVI1 in children with AML,and the clinical manifestations and prognosis differences between the positive and negative groups were compared.Results:（1）Among the 203 children with AML,the positive rate of EVI1 was 21.2%.There were 42 positive high EVI1 expressions and 1 case of low EVI1 expression.（2）There was no statistically significant difference in age,sex,hemoglobin,white blood cell,platelet count and peripheral blast between the EVI1 positive and EVI1 negative groups（P>0.05）.The most common FAB type of EVI1 positive group was the AML-M₅.The expression rate of EVI1 in M₀ and M₂ was different from that of other groups,and there was no significant difference in EVI1 expression rate of the other AML groups.（3）There were statistically significant differences in the event free survival（EFS）differences between the only chemotherapy and the hematopoietic stem cell transplantation（allo-HSCT）in children with positive children,chemotherapy alone group sees lower rate of EFS.（4）There was no statistically significant difference in the total remission rate between the EVI1 positive and EVI1 negative groups（P=0.242）,and the relapse rate in the EVI1 positive group was higher than that in the EVI1negative group,and the difference was statistically significant（P=0.022）.（5）EVI1 expression is not synchronized with MRD.（6）The correlation analysis suggested that CD10 expression was related to EVI1 expression.Conclusion:Children with EVI1-positive acute myeloid leukemia suggest shorter EFS and more relapses.EVI1 is an indicator of poor prognosis in children with AML.Allo-HSCT can improve the prognosis of children with EVI1-positive AML.Quantitative detection of EVI1 gene expression may not be suitable for monitor of minimal residual disease.Whether CD10 positive performance is used as a high expression feature of EVI1 needs further study.