伴CBFβ/MYH11阳性初诊AML患儿的预后影响因素分析

The Prognostic Factors for AML Children with CBFβ/MYH11 Positive

目的:分析伴CBFβ/MYH11阳性初诊急性髓系白血病(AML)患儿的预后影响因素。方法:选取2012年5月至2018年6月本院收治的原发性初治伴inv(16)/CBFβ-MYH11阳性AML患儿28例,对其临床资料及治疗效果等进行分析和评估。结果:所有患儿5年总生存(OS)率76.8%,5年无事件生存(EFS)率64.0%。单因素分析结果显示,WBC<60.0×10^(9)/L的患儿OS率为86.5%,显著性高于WBC≥60.0×10^(9)/L的患儿的50.0%(χ^(2)=3.891,P<0.05)。WBC<60.0×10^(9)/L的患儿EFS率为76.0%,显著性高于WBC≥60.0×10^(9)/L的患儿的37.5%(χ^(2)=4.588,P<0.05)。XRCC-Thr241Met野生型患儿EFS率为77.9%,显著性高于XRCC-Thr241Met变异型患儿的43.6%(χ^(2)=3.960,P<0.05)。Cox多因素生存分析显示,初诊WBC水平为影响该类患儿OS率的危险因素,初诊WBC水平及XRCC-Thr241Met是否野生型为影响该类患儿EFS率的危险因素。结论:初诊WBC水平及XRCC-Thr241Met基因型为影响伴CBFβ/MYH11阳性初诊AML患儿预后的主要因素。

Objective:To analyze the prognostic factors of AML children with CBFβ/MYH11 positive.Methods:Twenty-eight children with CBFβ/MYH11 positive treated in our hospital from May 2012 to June 2018 were selected,the clinical data and curative were analyzed and evaluated.Results:Five-year OS and 5-year EFS rate of CBFβ/MYH11positive AML children was 76.8%and 64.0%efficacy,respectively.Univariate analysis results showed that the OS rate of CBFβ/MYH11 positive AML children with WBC<60.0×10^(9)/L was 86.5%,which was significantly higher than those of CBFβ/MYH11 positive AML children with WBC≥60.0×10^(9)/L(χ^(2)=3.891,P<0.05).The EFS rate of CBFβ/MYH11positive AML children with WBC<60.0×10^(9)/L was 76.0%,which was significantly higher than those of AML children with WBC≥60.0×10^(9)/L(χ^(2)=4.588,P<0.05).The EFS rate of CBFβ/MYH11 positive AML children with XRCC-Thr241Met wild type was 77.9%,which was significantly higher than those of AML children with XRCC-Thr241Met variant(χ^(2)=3.960,P<0.05).Cox multivariate survival analysis results showed that WBC level at initial diagnosis was the risk factor for OS rate.The WBC level and XRCC-Thr241Met type at initial diagnosis were the risk factors for EFS rate.Conclusion:WBC level and XRCC-Thr241Met genotype at initial diagnosis are the major affecting factors for prognosis of AML children with CBFβ/MYH11 positive.