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目的探讨t(8;21)急性髓系白血病的特征及预后。方法回顾性分析80例初治t(8;21)AML患者,包括细胞遗传学G显带核型、免疫表型、细胞形态学、AML1/ETO融合基因、血象、乳酸脱氢酶(LDH)值及临床特征,并分析其预后因素。按染色体核型把患者分为单纯t(8;21)组(48例)、伴附加染色体异常组(32例)。结果80例t(8;21)AML患者中M277例,M41例,M4EO 2例;流式细胞仪检测t(8;21)AML患者免疫分型阳性率为:CD34 81.48%、CD13:96.29%、CD33:83.33%、HLA-DR90.74%、CD19:48.15%、CD56:55.55%;遗传学:48例(60.00%)为单纯t(8,21),32例(40.00%)有附加染色体异常,其中25例(31.25%)伴单纯性染色体丢失,7例(8.75%)为复杂变异型t(8;21)易位;初治时单纯t(8,21)组和伴有附加染色体组的年龄、性别、外周血和骨髓原始细胞数、血红蛋白(Hb)和血小板(PLT)计数、Auer小体、肝脾淋巴结浸润、LDH值、皮肤黏膜出血均无统计学意义(P均>0.05);伴有附加染色体组的外周血白细胞(WBC)计数和CD56阳性率均低于单纯组(P均<0.05)。伴附加染色体组与单纯组的CR率无明显差异(P>0.05);伴附加异常组的中位生存时间低于单纯t(8;21)组(P<0.05)。6例伴有髓外浸润患者的CR率和3年OS率均为0。结论伴附加染色体组与单纯t(8,21)组AML的临床特征有差异,附加染色体异常是t(8;21)AML的一种预后不良因素,伴有附加染色体异常的t(8;21)AML生存时间短于单纯t(8;21)者。
Objective To investigate the characteristics and prognosis of t (8; 21) acute myeloid leukemia. Methods A retrospective analysis of 80 untreated AML patients with AML1 / ETO fusion gene, hematoderm, lactate dehydrogenase (LDH) gene, immunophenotype, cytogenetics, Value and clinical features, and analyze its prognostic factors. Patients were divided into simple t (8; 21) group (n = 48) and chromosomal karyotype with additional chromosomal abnormalities (n = 32). Results The positive rate of immunophenotyping of AML patients detected by flow cytometry was 81.48% for CD34 and 96.29% for CD13, in 80 cases of t (8; 21) AML patients with M277, M41 and M4EO. , 83.33% of CD33, 90.74% of HLA-DR, 48.15% of CD19 and 55.55% of CD56. Genetics: 48 cases (60.00%) were simple t Among them, 25 (31.25%) patients had simple chromosome loss and 7 (8.75%) patients had complex variant t (8; 21) translocation. In the untreated group, t (8,21) There were no significant differences in age, sex, peripheral blood and bone marrow blast cells count, hemoglobin (Hb) and platelet count (PLT), Auer body, infiltration of liver and spleen lymph nodes, LDH value and mucocutaneous bleeding ); WBC count and CD56 positive rate with additional chromosome group were lower than those in simple group (all P <0.05). There was no significant difference in the CR rate between the additional chromosome group and the simple group (P> 0.05). The median survival time of the group with additional abnormalities was lower than that of the pure t (8; 21) group (P <0.05). The CR rate and 3-year OS rate of 6 patients with extramedullary infiltration were all 0. Conclusions The clinical features of AML with additional chromosomes and t (8,21) group are different. Additional chromosomal abnormalities are a poor prognostic factor for t (8; 21) AML with t (8; 21 ) AML survival time shorter than simple t (8; 21) who.