摘要
目的探讨EVI1基因阳性急性髓系白血病(AML)患者的临床特点、预后并与EVI1基因阴性AML患者进行比较。方法观察309例AML病例,分析EVI1基因阳性AML患者的临床特征、细胞形态学、融合基因、早期死亡(ED)、CR率、总体生存率(OS)、无复发生存率(RFS)、造血干细胞移植效果等,并与EVI1基因阴性AML患者进行比较。结果 EVI1基因阳性AML患者白细胞数显著增高(P<0.05),FAB分型中M4/M5比例偏高(P<0.05)。EVI1阳性患者的染色体核型主要为预后较差的11q23(MLL基因阳性)、inv(3)/t(3;3)、-7等重现性染色体异常,而一些预后较好的核型如t(15;17)、t(8;21)、inv(16)发生率较低。EVI1基因阳性AML患者CR率明显低于EVI1基因阴性者(54.3%∶74.1%)(P<0.05)。allo-HSCT可明显提高EVI1基因阳性AML患者OS(P<0.05)。结论 EVI1基因阳性AML白细胞数高,生存期短,化疗效果差,预后不良。
Objective To investigate the clinical characteristics and prognosis of acute myoloid leukimia patients with positive expression of EVI1 gene. Methods A total of 309 AML cases were retrospectively reviewed. The clinical features,cytomorphology,cytogenetics,early death,complete remission rate,overall survival,relapse-free survival and response to allo-HSCT of AML patients with EVI1 gene positive expression were investigated and compared with patients with EVI1 gene negative expression. Results Compared with the EVI1 gene negative expression group,the WBC in EVI1 gene positive expression AML patients increased significantly（ P〈 0. 05）. Otherwise,the percentage of M4 / M5 in these patients was higher according to FAB classification（ P〈 0. 05）. EVI1 gene positive expression was associated with specific recurrent chromosome abnormalities,including11q23（ MLL gene rearrangement） 、inv（ 3） / t（ 3; 3）,monosomy 7,while some favorable risk cytogenetics such as t（ 15; 17）,t（ 8; 21） and inv（ 16） were almost exclusive. The AML patients with EVI1 gene positive expression had lower CR rate compared with EVI1 gene negative expression group（ 54.3% versus 74. 1%）（ P〈 0. 05）. Among patients with EVI1 gene positive expression,the cases received allo-HSCT had a higher OS（ P〈 0. 05）. Conclusion Compared with EVI1 gene negative expression AML patients,the patient with EVI1 gene positive expression have higher WBC count,poor response to chemotherapy and poor prognosis.
出处
《实用临床医药杂志》
CAS
2016年第9期32-36,共5页
Journal of Clinical Medicine in Practice
