{"id":483,"date":"2010-05-31T16:40:15","date_gmt":"2010-05-31T14:40:15","guid":{"rendered":"http:\/\/www.pjh.fr\/wordpress\/?p=483"},"modified":"2011-10-19T01:42:57","modified_gmt":"2011-10-18T23:42:57","slug":"impact-pronostic-de-cebpa-et-interaction-avec-flt3-et-npm1","status":"publish","type":"post","link":"http:\/\/www.pjh.fr\/wordpress\/?p=483","title":{"rendered":"Impact pronostic de CEBPA et interaction avec FLT3 et NPM1"},"content":{"rendered":"<p><a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pubmed\/20439648\"><span style=\"font-size: small;\">Prognostic Significance of CEBPA Mutations in a Large  Cohort of Younger Adult Patients With Acute Myeloid Leukemia: Impact of  Double CEBPA Mutations and the Interaction With FLT3 and NPM1 Mutations.<\/span><\/a><span style=\"font-size: small;\"><br \/>\nGreen  CL, Koo  KK, Hills  RK, Burnett  AK, Linch  DC, Gale  RE.<\/span><br \/>\nJ Clin Oncol. 2010 Jun  1;28(16):2739-47. Epub  2010 May 3.<span style=\"font-size: small;\"><br \/>\nPMID:  20439648 [PubMed &#8211; in process]<\/span><\/p>\n<p><span style=\"font-size: small;\">La prise en charge des leuc\u00e9mies aigu\u00ebs my\u00e9loblastiques (LAM) est de plus en plus une strat\u00e9gie sur le risque de la maladie. La cytog\u00e9n\u00e9tique a permis de classer les LAM en trois groupes : bon pronostic (t(8;21), inv(16), t(15;17)), mauvais pronostic (caryotype complexe, anomalies du 7&#8230;) et de pronostic \u00ab\u00a0interm\u00e9diaire\u00a0\u00bb en particulier pour les LAM \u00e0 caryotype normal dont l&rsquo;\u00e9volution \u00e9tait tr\u00e8s variable. L&rsquo;arriv\u00e9e de la biologie mol\u00e9culaire a permis de mettre en \u00e9vidence des mutations ou anomalies de g\u00e8nes qui ont int\u00e9r\u00eat pronostic dans ces LAM \u00e0 caryotype normal (FLT3, NPM1 et CEBP\u03b1, 3 g\u00e8nes dont l&rsquo;\u00e9tude fait maintenant partie des analyses de \u00ab\u00a0routine\u00a0\u00bb et plus r\u00e9cemment les g\u00e8nes IDH1 et IDH2).<\/span><\/p>\n<p><span style=\"font-size: small;\">Les mutations de CEBPA sont retrouv\u00e9s dans 10% des LAM, en particulier dans ce groupe de patients \u00e0 risque interm\u00e9diaire. Elles seraient associ\u00e9es \u00e0 un bon pronostic. La r\u00e9alit\u00e9 serait plus complexe d&rsquo;apr\u00e8s quelques \u00e9tudes plus r\u00e9cents :<\/span><\/p>\n<ul>\n<li><span style=\"font-size: small;\">seule les mutations doubles de CEBPA seraient de bon pronostic (Wouters BJ et al: Blood 113:3088, 2009 et Pabst T et al: Br J Cancer)<br \/>\n<\/span><\/li>\n<li><span style=\"font-size: small;\">le bon pronostic ne serait \u00e9galement conserv\u00e9 qu&rsquo;en l&rsquo;absence de duplication en tandem de FLT3 (Renneville A. et al: Blood 113:5090 2009)<\/span><\/li>\n<\/ul>\n<p>Les auteurs ont repris ici 107 patients avec mutations de CEBPA parmi 1427 patients trait\u00e9s dans les protocoles du MRC de 1988 \u00e0 2002, soit <strong>7% de patients porteurs de mutations<\/strong>.<\/p>\n<blockquote><p><strong>Qu&rsquo;en retenir ?<\/strong><\/p>\n<ol>\n<li><strong>Les patients porteurs d&rsquo;une double mutation\u00a0 ont une meilleure survie \u00e0 8 ans (54% vs 34% CEBPA wild type vs 31% CEBPA simple mutation)<\/strong><\/li>\n<li><strong>Ce b\u00e9n\u00e9fice en survie dispara\u00eet en cas d&rsquo;association \u00e0 une duplication en tandem de FLT3<\/strong><\/li>\n<\/ol>\n<\/blockquote>\n\n<div class=\"pdf24Plugin-cp\"> \t<form name=\"pdf24Form0\" method=\"post\" action=\"https:\/\/doc2pdf.pdf24.org\/wordpress.php\" target=\"pdf24PopWin\" onsubmit=\"var pdf24Win = window.open('about:blank', 'pdf24PopWin', 'resizable=yes,scrollbars=yes,width=600,height=250,left='+(screen.width\/2-300)+',top='+(screen.height\/3-125)+''); 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Green CL, Koo KK, Hills RK, Burnett AK, Linch DC, Gale RE. J Clin Oncol. 2010 Jun 1;28(16):2739-47. Epub 2010 May 3. PMID: 20439648 [PubMed [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":285,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[87],"tags":[20,19,32,16,18],"_links":{"self":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/483"}],"collection":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=483"}],"version-history":[{"count":11,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/483\/revisions"}],"predecessor-version":[{"id":795,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/posts\/483\/revisions\/795"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=\/wp\/v2\/media\/285"}],"wp:attachment":[{"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=483"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=483"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.pjh.fr\/wordpress\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=483"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}