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急性早幼粒细胞白血病(APL)是急性髓系白血病(AML)的一种特殊亚型。近年来随着全反式维甲酸和三氧化二砷的靶向治疗日益规范化,APL的预后已很大程度上得到提高,成为AML中预后最好的亚型,但仍有15%的患者发生复发。越来越的学者致力于研究影响APL预后的因素,以往很多人们关注过的因子在近来的研究中也发现在APL中起着重要的作用,如FLT3、CD56、Fas等,以及新近证实的一些特殊基因的表达也影响着APL的预后,BAALC低表达与APL预后正相关,与其相反Ets相关基因(ERG)高表达与APL预后负相关。在此本文总结了近年来人们在APL预后研究的进展,这些因素的发现,使人们对APL发病机制有了更深一层的了解,便于临床上早期对APL患者进行危险分层,对高风险的APL患者采用个体化治疗,也可成为日后治疗APL的新靶点。
Acute promyelocytic leukemia (APL) is a specific subtype of acute myeloid leukemia (AML). In recent years, with the increasingly standardization of targeted therapy of all-trans retinoic acid and arsenic trioxide, the prognosis of APL has been greatly improved, making it the best prognosis subtypes in AML. However, 15% of patients still have recurrence. More and more scholars devoted themselves to studying the factors affecting the prognosis of APL. In the past, many factors of interest have also been found in recent studies that play an important role in APL, such as FLT3, CD56, Fas, etc., as well as some newly confirmed The expression of special genes also affected the prognosis of APL. The low expression of BAALC was positively correlated with the prognosis of APL. In contrast, the high expression of Ets related gene (ERG) was negatively correlated with the prognosis of APL. This article summarizes the progress of APL prognosis research in recent years, the discovery of these factors, so that people have a deeper understanding of the pathogenesis of APL, to facilitate the early clinical risk stratification of patients with APL, high-risk APL patients with individualized treatment, but also can be a new target for future treatment of APL.