国际输血及血液学杂志
國際輸血及血液學雜誌
국제수혈급혈액학잡지
INTERNATIONAL JOURNAL OF BLOOD TRANSFUSION AND HEMATOLOGY
2012年
4期
315-317
,共3页
急性早幼粒细胞白血病%不典型t(15%17)%预后
急性早幼粒細胞白血病%不典型t(15%17)%預後
급성조유립세포백혈병%불전형t(15%17)%예후
acute promyelocytic leukemia%atypical t(15%17)%prognosis
目的 探讨伴不典型t(15;17)易位的急性早幼粒细胞白血病(APL)患者的预后特征.方法 收集本院2011年5月至9月收治2例的伴不典型t(15;17)易位APL患者为研究对象.按常规方法制备患者染色体,经R显带进行核型分析,实时定量PCR检测PML/RARα融合基因(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准,得到该伦理会批准,分组征得受试对象本人的知情同意,并与之签订临床研究知情同意书).结果 2例APL患者伴不典型t(15;17)易位核型,分别是46,XY,t(8;17;15)(q22;q21;q22)和45,X,-Y,t(11;17)(q23;q21).前者PML/RARα融合基因阳性,全反式维甲酸(ATRA)+三氧化二砷(ATO)诱导治疗4周后,骨髓形态学达到完全缓解(CR);后者PLZF-RARα融合基因,采用ATRA+ATO+柔红霉素(DNR)治疗6周后复查骨髓象,异常早幼粒细胞仍占80％,于1个月后死于全身性出血,从开始接受治疗计算,总生存期仅为72 d.结论 伴不典型t(15;17)易位,但PML/RARα融合基因阳性APL患者对ATRA治疗敏感,预后良好,而伴t(11;17) (q23;q21)/PLZF-RARα融合基因阳性APL患者对ATRA不敏感,预后不良.
目的 探討伴不典型t(15;17)易位的急性早幼粒細胞白血病(APL)患者的預後特徵.方法 收集本院2011年5月至9月收治2例的伴不典型t(15;17)易位APL患者為研究對象.按常規方法製備患者染色體,經R顯帶進行覈型分析,實時定量PCR檢測PML/RARα融閤基因(本研究遵循的程序符閤本院人體試驗委員會所製定的倫理學標準,得到該倫理會批準,分組徵得受試對象本人的知情同意,併與之籤訂臨床研究知情同意書).結果 2例APL患者伴不典型t(15;17)易位覈型,分彆是46,XY,t(8;17;15)(q22;q21;q22)和45,X,-Y,t(11;17)(q23;q21).前者PML/RARα融閤基因暘性,全反式維甲痠(ATRA)+三氧化二砷(ATO)誘導治療4週後,骨髓形態學達到完全緩解(CR);後者PLZF-RARα融閤基因,採用ATRA+ATO+柔紅黴素(DNR)治療6週後複查骨髓象,異常早幼粒細胞仍佔80％,于1箇月後死于全身性齣血,從開始接受治療計算,總生存期僅為72 d.結論 伴不典型t(15;17)易位,但PML/RARα融閤基因暘性APL患者對ATRA治療敏感,預後良好,而伴t(11;17) (q23;q21)/PLZF-RARα融閤基因暘性APL患者對ATRA不敏感,預後不良.
목적 탐토반불전형t(15;17)역위적급성조유립세포백혈병(APL)환자적예후특정.방법 수집본원2011년5월지9월수치2례적반불전형t(15;17)역위APL환자위연구대상.안상규방법제비환자염색체,경R현대진행핵형분석,실시정량PCR검측PML/RARα융합기인(본연구준순적정서부합본원인체시험위원회소제정적윤리학표준,득도해윤리회비준,분조정득수시대상본인적지정동의,병여지첨정림상연구지정동의서).결과 2례APL환자반불전형t(15;17)역위핵형,분별시46,XY,t(8;17;15)(q22;q21;q22)화45,X,-Y,t(11;17)(q23;q21).전자PML/RARα융합기인양성,전반식유갑산(ATRA)+삼양화이신(ATO)유도치료4주후,골수형태학체도완전완해(CR);후자PLZF-RARα융합기인,채용ATRA+ATO+유홍매소(DNR)치료6주후복사골수상,이상조유립세포잉점80％,우1개월후사우전신성출혈,종개시접수치료계산,총생존기부위72 d.결론 반불전형t(15;17)역위,단PML/RARα융합기인양성APL환자대ATRA치료민감,예후량호,이반t(11;17) (q23;q21)/PLZF-RARα융합기인양성APL환자대ATRA불민감,예후불량.
Objective To explore the prognostic characteristic of acute promyelocytic leukemia(APL)with atypical t(15;17).Methods Form May 2011 to September,two cases of APL patients with atypical t(15;17) who treated in Xinghua People's Hospital were collected in this study.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Xinghua People's Hospital.Informed consent was obtained from all participants. Cytogenetic examination of bone marrow was performed by 24 h culture method.R banding technique was used for karyotype analysis.29 fusion genes including PML/RARα and PLZF-RARα were detected by multiple nested real time (RT)-PCR.Results Chromosome analysis revealed atypical t(15;17) including 46,XY,t(8;17;15)(q22;q21;q22) in case 1 and t(11;17) (q23;q21) in case 2.PML/RARα and PLZF-RARα fusion genes were detected by RT-PCR,respectively.Case 1 obtained complete remission after the treatment with all-trans retinoic acid (ATRA) and arsenic trioxide (ATO).But the case 2 whose abnormal promyelocytic cells was account for 80％ after the treatment with ATRA+ATO+DNR,was dead because of systemic bleeding.Conclusions The prognosis is good in the case of APL with atypical t(15 ; 17) and PML/RARα fusion genes expression while it is poor in the case of APL with t(11;17) and PLZF-RARα fusion genes expression.
