急性髓系白血病和骨髓增生异常综合征患者NPM基因突变的研究

目的探讨染色体核型正常的急性髓系白血病（AML）和骨髓增生异常综合征（MDS）患者NPM基因突变。方法染色体核型正常的AML患者40例（初治28例，首次完全缓解期12例），MDS患者33例，用基因组DNAPCR法扩增NPM基凶第12外显子，PCR产物纯化后直接测序，发现突变患者，将PCR产物克隆至pUCm—T载体，转化大肠杆菌DH5α，至少挑选5个以上重组克隆，小量制备质粒后进行测序。结果共发现NPM突变患者6例（AML4例，MDS2例），A型突变4例，B型突变1例，新发现突变1例（命名为R型）。结论新发现了一个NPM突变类型，并在国内外首次证实MDS患者也存在NPM基凶突变，为进一步研究NPM突变与AML及MDS发生的关系提供了重要线索．

Study of nucleophosmin (NPM) gene mutation in patients with acute myeloid leukemia and myelodysplastic syndromes

OBJECTIVE: To investigate nucleophosmin (NPM) gene mutations in patients with de novo acute myeloid leukemia (AML) with normal cytogenetics and primary myelodysplastic syndromes (MDS). METHODS: Genomic DNA corresponding to exon 12 of NPM gene was amplified by polymerase chain reaction (PCR) in 40 AML patients (28 case untreated and 12 in first remission) and 33 MDS patients. The PCR products were purified and screened by direct sequencing, the mutation PCR products were cloned into pUCm-T vector and then transfected into E. coil DH5alpha. At least 5 recombinant colonies were selected, and plasmid DNA were prepared and sequenced. RESULTS: NPM mutations were found in 6 patients (4 newly diagnosed AML and 2 MDS): 4 were type A,1 type B, and 1 novel sequence variant ( named as type R). CONCLUSION: A new type of NPM mutation was found, and NPM mutations in MDS patients were demonstrated for the first time. The results provides new hints for NPM gene mutations in the pathogenesis of AML and MDS.