AML1/ETO阳性急性髓系白血病的生物学特征及预后分析

Analysis of molecular characteristics and prognosis in acute myeloid leukemia patients with AML1/ETO

目的 分析AML1/ETO阳性急性髓系白血病（AML）患者的分子生物学特征及多因素对其预后的影响.方法 回顾分析63例AML1/ETO阳性AML患者的细胞形态学、免疫分型、细胞遗传学、分子生物学特征、临床疗效、预后等资料,以同期收治的56例AML1/ETO阴性的AML患者作为对照.结果 63例AML1/ETO阳性的AML患者中,M2a占57.12％（36例）,M2b占33.33％（21例）.初诊时骨髓原始细胞比例为0.46±0.16.CD34、CD13、CD33、CD19、CD7、CD56阳性率分别为67.21％、52.46％ 、40.98％、63.93％、4.92％、50.82％.伴t（8;21）占82.54％,附加染色体占4.76％.3例伴EV11融合基因表达,1例伴MLL/AT9融合基因表达.总缓解率、复发率、3年及5年预计总体生存（OS）率分别为71.43％、51.11％、（43.01 ±5.31）％、（32.79±3.81）％,与对照组比较差异均无统计学意义（均P＞ 0.05）.髓外浸润、是否表达CD56、有无附加染色体对OS率有影响（P＜0.05）.结论 AML1/ETO阳性的AML有其独特的特点,疗效和预后受多因素影响,不能单独依靠AML1/ETO融合基因来评估其疗效及预后.

Objective To analyze the molecular characteristics and prognosis in acute myeloid leukemia patients with AML1/ETO.Methods The clinical data of 63 cases of acute myeloid leukemia （AML） patients with AML1/ETO positive were analyzed retrospectively.56 cases of AML patients with AML1/ETO negative in the same period were analyzed as control.Characteristics in morphology,immunology,cytogenetics,molecular biology and the clinical effects of treatment were studied and analyzed.Results M2a was 57.12 % （36/63）,M2b was 33.33 % （21/63） in AML with AML1/ETO.The percent of initial marrow blasts was 0.46±0.16.The positive rate of CD34,CD13,CD33,CD19,CD7 and CD56 was 67.21%,52.46 %,40.98 %,63.93 %,4.92 % and 50.82 %,respectively.The rate of t（8;21） translocation was 82.54 %.There was 4.76 % with additional chromosome abnormality,three cases with EV1 1and one case with MLL/AT9.The overall CR rate,the relapse rate,the 3-year and the 5-year overall survival rate was 71.43 %,51.11%,（43.01±5.31） % and （32.79±3.81） %,respectively.There was no significant difference compared with the control group （P 〉 0.05）.But extramedullary infiltration,the expression of CD56 and additional chromosome abnormality had statistical effects on overall survival （P 〈 0.05）.Conclusions There has unique characteristics in AML with AML1/ETO.The effects of treatment and the prognosis are affected by many factors,so the efficacy and prognosis of AML with AML1/ETO couldn＆#39; t just depend on AML1/ETO.