AML-M_2型患者AML1/ETO基因表达及其临床意义

The Expression of AML1/ETO Gene in Adult Patients with AML-M_2 Subtype and Its Clinical Significance

目的:分析AML1/ETO(AE)基因mRNA在成年人急性髓系白血病M2型(AML-M2)患者中的表达,探讨其与临床表现、疗效的关系以及在预后判断中的意义。方法:采用巢式RT-PCR技术,首先分析AML-M2型患者AE基因mRNA的表达。在此基础上,进一步比较AE基因mRNA表达阳性(A组)与阴性(B组)患者的临床资料、治疗反应并进行随访研究。结果:23例成人AML-M2型患者中12例检测到AE基因mRNA表达,其中,M2a11例,M2b1例。A组患者较B组平均年龄轻,易出现发热,外周血白细胞计数偏低,原始细胞数较高。化疗后,A组中9例患者达到缓解,而B组中仅有4例患者达到缓解。B组患者中有1例在缓解后的第4个月复发并因中枢神经系统白血病而死亡,另有1例在缓解后的第7个月复发;A组患者在8个月随访中无一例复发。结论:部分成人AML-M2患者表达AE基因,这些患者易出现发热,但治疗效果较好,预后良好。

Objective： To investigate the expression of AML1/ETO （AE） gene mRNA in adult patients with acute myeloid leukemia-M2 subtype （AML-M2） and the relationship between the expression of AE and clinical manifestation, therapeutic efficacy and prognosis. Methods： The expression of AE gene was firstly analyzed by nest reverse transcription polymerase chain reaction. The clinical manifestation and the therapeutic efficacy between AE-positive （A） group and AEnegative （B） group were compared,and the significance in prognosis after 8 month following-up was also evaluated. Results： Twelve of 23 AML-M2 patients expressed AE gene mRNA, which included eleven cases of M2, and one case of M2. Compared to the patients in group B, the patients in group A were younger, easier to get fever,lower peripheral white blood cell and higher blast cell count. After chemotherapy,9 patients in group A achieved complete remission （CR）. Only 4 patients in group B got CR,in which one patient relapsed at the fourth month after CR and died of central nervous system leukemia, and one patient relapsed at the seventh month after CR. In contrast, none of patients in group A relapsed during 8 month following-up. Conclusion： Part of adult AML-M2 patients express AE gene and easily get fever,but the treatment efficacy and prognosis for these patients are better than that for patients in group B.