CRLF2蛋白在成人非Ph阳性急性B淋巴细胞白血病中的表达特点及其预后意义

The expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia and its prognosticsignificance

目的检测CRLF2蛋白在初诊成人非Ph阳性急性B淋巴细胞白血病（B．ALL）中的表达情况，探讨CRLF2蛋白的表达与患者临床特征、疗效及预后的关系。方法收集郑州大学附属肿瘤医院血液科2016年4月1日至2017年12月31日收治的103例初治成人B-ALL患者骨髓标本，应用流式细胞术CD45／SSC设门检测原始细胞CRLF2表达率，将CRLF2表达率≥20％定义为高表达组，〈20％定义为低表达组，比较两组患者的临床特征及预后差异。结果CRLF2高表达组中位总生存（OS）、无病生存（DFS）时间分别为9．0和4．25个月，CRLF2低表达组分别为15．5和10．25个月，差异有统计学意义（JP值分别为O．007、0．000）。CRLF2高表达组18个月OS率、DFS率分别为38．6％和25．1％，CRLF2低表达组分别为57．8％和42．3％，差异有统计学意义（P值分别为0．047、0．016）。多因素分析显示CRLF2高表达是影响患者OS（HR=2．991，95％C11．429-6．261，P=0．004）和DFS（HR=2．374，95％C11．146-4．960，P=0．041）的独立危险因素。结论合并CRLF2高表达的成人初治B-ALL患者预后不良。

Objective To detect the expression of CRLF2 in adult Ph negative acute B lymphocytic leukemia （B-ALL） in newly diagnosed cases, and to investigate the relationship between CRLF2 and the general clinical characteristics, efficacy and prognosis. Methods 103 cases of newly diagnosed adult B-ALL patients were investigated from Apr 2016 to Dec 2017 in the Department of Hematology, Henan Cancer Hospital. Bone marrow samples was used to detect the expression of CRLF2 in leukemic cells. The expression of CRLF2 ≥20% was defined as CRLF2-high group and 〈 20% was defined as CRLF2-1ow group. The clinical characteristics and prognosis of the two groups were compared. Results The Median overall survival （OS） and disease free survial （DFS） in CRLF2-high group were 9.0 months and 4.25 months, respectively. CRLF2-1ow group were 15.5 months and 10.25 months, respectively. There was a statistically significant difference in median OS and DFS between the two groups （P= 0.007, P= 0.000）, The 18-month OS and DFS in CRLF2-high group were 38.6% and 25.1%, respectively. CRLF2-1ow group were 57.8% and 42.3%, respectively. Multivariate analysis showed high expression of CRLF2 was an independent risk factor for OS （HR = 2.991, 95% CI 1.429-6.261, P = 0.004） and DFS （HR = 2.374, 95% CI 1.146-4.960, P = 0.041 ） in patients. Conclusion Patients with high expression of CRLF2 had poor prognosis.