Objective To investigate the effect of leukemia-related genes on drug resistance in patients with acute myeloid leukemia (AML). Methods 74 patients with newly diagnosed AML were selected and 54 leukemia-associated genes of all patients were sequenced by second-generation gene sequencing. The gene with the highest mutation rate was further analyzed in association with resistance to several common chemotherapy medicines in in vitro drug sensitivity assays. In addition, in vitro drug resistance data were compared with the clinical data of patients. Results The TET2 gene was the most frequent mutation among 74 patients with newly diagnosed AML, with 11 positive patients. Among these 11 TET2 positive patients, 9 (81. 82％ ) were resistant to daunorubicin, while only 4 (6. 35％ ) out of 63 TET2 negative patients were resistant to daunorubicin. Besides, there was no significant difference between in vitro resistance rate to daunorubicin and the clinical data of patients. Conclusion TET2 gene mutation is associated with resistance to daunorubicin in AML patients, which may become an important indicator of the therapeutic efficacy of DA regimen.%目的 探讨白血病相关基因对于急性髓系白血病(AML)患者耐药性的影响.方法 选取74例AML初诊患者,对所有患者的54个白血病相关基因采用二代测序仪进行测序,选取突变率最高的基因为研究指标,对比体外药敏试验中对于常见化疗药物耐药性的差异,同时将体外耐药率与实际耐药率进行对比.结果 74例AML初诊患者中,突变率最高的基因为TET2基因,其中11例检测到TET2基因突变,体外药敏试验显示对于柔红霉素的耐药率最高,其中 9例(81. 82％)对其耐药,在63例TET2突变阴性的患者中,体外药敏试验显示仅4例(6. 35％)对柔红霉素产生耐药;体外药敏试验显示的柔红霉素的耐药率与患者实际发生耐药的比例无明显差异.结论 TET2基因突变增加了 AML对于柔红霉素耐药的发生,其可能成为判断DA方案疗效的重要指标.
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