摘要
目的分析影响t（8；21）急性髓系白血病M2型（AML—M2）预后的因素。方法应用吉姆萨显带法染色体核型分析，结合临床资料对94例行染色体检查的初治FAB分型AML—M2患者的预后影响因素进行回顾性分析。结果t（8；21）（q22；q22）占FAB分型AML—M：患者53．2％。有附加染色体异常的t（8；21）患者的CR率及中位总生存期（0s）均低于单纯t（8；21）及正常核型患者（P〈0．05），单纯t（8；21）患者的CR率及中位总生存期（OS）与正常核型患者差异无统计学意义（P〉0．05）。72例患者按照白细胞指数分为〈2．5、≥2．5〈20、≥20三组，三组患者的缓解率差异无统计学意义（P〉0．05），但是三组的中位生存时间差异有统计学意义（P〈0．05），白细胞指数〈2．5组中总生存时间最长。结论t（8；21）见于53．2％的AML—M2患者，其中伴附加染色体异常占46％，主要是性染色体的缺失；t（8；21）伴附加染色体异常患者与单纯t（8；21）及正常核型患者相比，缓解率低、生存期短，是不良的预后因素。而单纯t（8；21）患者与正常核型患者疗效一致；白细胞指数对缓解率无明显影响，但对生存期有影响。
Objective To investigate the prognostic factors in acute myeloid leukemia subtype M2 （AML-M2） patients with chromosome translocation of 8 and 21. Methods By using G-banding analyses karyotype and combining the clinical data, prognostic factors in 94 cases of de novo adult AML-M2 in our hospital from 2001 to 2007 were retrospectively analyzed. Results Chromosome 8 and 21 translocation were identified in 53.2 % （50/94） of AML-M2 cases. In the patients with other aberrations in addition to t（8;21）, their complete remission （CR） rates, overall survival （OS） was lower than the patients with sole t （8;21） and normal karyotype（P 〈0.05）. And the patients with sole t （8;21） whose CR rates and OS had no difference with patients with normal karyotype （P 〉0.05）. The patients were divided into 3 subgroups （low index, less than 2.5; intermediate index, 2.5-20; high index, 20 or more） according to WBC index. The CR had no difference among the 3 subgroups, but the OS of the 3 subgroups was different （P〈0.05）. The OS in the lowest index group was longer than that in the others. Conclusion Cytogenetically, 53.2% cases had chromosome 8 and 21 translocation, 46 % cases had t（8;21） with additional chromosomal abnormalities, and the main additional abnormalities were loss of a sex chromosome （LOS）. t（8;21） AML-M2 patients with additional chromosome abnormalities had low complete remission rate and shorter survival time, and its prognosis was poorer. WBC index have no influence on complete remission rate but effected the survival time.
出处
《白血病．淋巴瘤》
CAS
2009年第8期458-460,共3页
Journal of Leukemia & Lymphoma
