Лейкозы и миелодиспластические синдромы с высокой экспрессией гена evi1: теоретические и клинические аспекты

EVI1 gene overexpression was evidenced and analyzed in 27 patients (17 males, 10 females, mean age 34,3 ± 18,4 years) with acute myeloid leukemia (AML, n = 9), myelodysplastic syndromes (MDS, n = 3), chronic myeloid leukemia, resistant to tyrosine-kinase inhibitors (CML, n = 14), and Ph+ acute lymphoblastic leukemia (Ph+ ALL, n = 1). The higher levels of EVI1 gene expression (69,03 and 55,48 per 100 expressions of ABL gene) were diagnosed in patients with AML and Ph+ ALL, respectively. According to our data, the levels of EVI1 gene expressions ranged from 4,01 to 52,1 and from 10,36 to 69,03 per 100 expressions of ABL gene in patients with CML and AML-MDS, respectively. These pts. are characterized by different cytogenetic and molecular profiles, but EVI1 gene overexpression is not associated with such poor prognostic mutation of BCR/ABL gene as T3151. Despite allogeneic haematopoietic stem cell transplantation (HSCT) is considered to be a single curative approach in these patients, it was not successful in our study. It may be explained by late and unjustified alloHSCT at first remission. Probability of alloHSCT may be benefit in combination with such new therapeutic strategies as mTOR inhibitors, hypomethylating agents, and alemtuzumab.