AML1-ETO融合基因转阴对急性髓细胞白血病预后的影响

The effect of AML1-ETO fusion gene switched on the prognosis of patients in acute myeloid leukemia

目的:探讨AML1-ETO融合基因阳性表达的急性髓细胞白血病(acute myelocytic leukemia,AML)患者治疗后融合基因转阴及转阴时间长短对AML患者预后的影响。方法:对2012年1月1日至2016年12月31日在中国医科大学附属盛京医院住院治疗的35例初诊AML1-ETO融合基因阳性AML患者的临床资料进行回顾性分析,总结其形态学、免疫学和分子生物学特征,用Kaplan-Meier曲线评估患者生存情况。结果:35例患者男女比例1.33∶1,中位年龄为34岁(15~71岁)。中位随访时间为16(4~61)个月,诱导缓解率为82.9%,3个疗程或以上缓解占14.3%(n=5),始终未缓解占2.9%(n=1),复发率35.3%(n=12),复发中位时间12(6~20)个月。其中11例治疗后融合基因转阴,包括3个月内转阴占63.6%(n=7),大于3个月转阴占36.4%(n=4)。单因素分析表明AML1-ETO融合基因转阴患者OS和PFS高,预后较好,AML1-ETO融合基因转阴时间长短对患者长期生存的影响无统计学意义(P=0.707)。结论:AML1-ETO融合基因转阴的AML患者预后较好,AML1-ETO融合基因转阴时间长短对患者的长期生存无明显影响。

Objective：To investigate the effect of AML1 - ETO fusion gene switched time on the prognosis of post-treatment patients in acute myeloid leukemia （AML）. Methods ：The clinical data of 35 newly diagnosed AML patients with AML1 - ETO fusion gene, treated in Shengjing Hospital Affiliated to China Medical University from 2012- 01 - 1 to 2016 - 12 - 31, were retrospectively analyzed. Their characteristics of morphology, immunology and molecular biology were summarized and their survival were evaluated by Kaplan - Meier curve. Results ： The male to female ratio of 35 patients with AML1 - ETO gene was 1.33： 1, and the median age was 34 years （ 15 -71 years）. The medi- an follow -up was 16 months （4 -61 ）. The remission rate was 82.9 % . 3 cycles or more remission accounted for 14.3% （n =5） and never remission accounted for 2.9% （n = 1 ）. Recurrence rate was 35.3% （n = 12）. The median time of recurrence was 12 months （6 ~ 20）. There were 11 patients with AML1 -ETO fusion gene switched after treatment,within 3 months accounting for 63.6% （ n = 7） and more than 3 months accounting for 36.4% （ n =4）. One - way analysis showed that in patients with AML1 - ETO fusion gene switched, the OS and PFS were longer and their prognosis were better than still positive ones. The length of AML1 - ETO fusion gene switched time had no statistical significance to the long term survival of patients （ P = 0.707 ）. Conclusion ： The prognosis of AML patients with AML1 - ETO fusion gene switched were better than still positive one. The long - term survival has no significant effect on the patients by the length of AML1 - ETO fusion gene switched duration.