CAJ | 학술논문

目的分析t(8;21)急性髓系白血病(AML)患者的细胞形态学、免疫表型、遗传学、分子生物学(MICM)分型及临床治疗疗效.方法运用瑞特染色法、FAB细胞形态分类标准、流式细胞术(FCM)直接免疫荧光标记技术、遗传学染色体吉姆萨显带技术及RT-PCR技术对70例确认有t(8;21)与AML1-ETO融合基因双阳性的AML患者及70例正常染色体核型的AML患者进行分析和比较.结果 70例t(8;21)AML患者中M11例,M2 64例,M4 3例,无法分型的急性白血病(AL)2例;免疫表型分析发现CD13、CD33、CD34、CD117高表达,40%表达CD19,11%表达CD15,10%表达CD11b,7%表达CD7;遗传学显示50%的t(8;21)AML患者有附加染色体异常,主要为性染色体丢失、9q-及超二倍体;RT-PCR检测AML1-ETO融合基因100%阳性.CD+19t(8;21)AML患者完全缓解(CR)率72%,CD+19伴CD+7t(8;21)AML患者CR率为0,正常核型CR率31%.结论 t(8;21)AML患者主要在M2中集中出现,附加染色体异常较多见.CD19表达较高,而CD7表达极低,CD34、CD117高表达,这些抗原的表达可能与核型密切相关.CD+19是预后良好的指标,但同时出现CD+7,则预后不良.
목적 분석t(8;21)급성수계백혈병(AML)환자적세포형태학、면역표형、유전학、분자생물학(MICM)분형급림상치료료효.방법 운용서특염색법、FAB세포형태분류표준、류식세포술(FCM)직접면역형광표기기술、유전학염색체길모살현대기술급RT-PCR기술대70례학인유t(8;21)여AML1-ETO융합기인쌍양성적AML환자급70례정상염색체핵형적AML환자진행분석화비교.결과 70례t(8;21)AML환자중M11례,M2 64례,M4 3례,무법분형적급성백혈병(AL)2례;면역표형분석발현CD13、CD33、CD34、CD117고표체,40%표체CD19,11%표체CD15,10%표체CD11b,7%표체CD7;유전학현시50%적t(8;21)AML환자유부가염색체이상,주요위성염색체주실、9q-급초이배체;RT-PCR검측AML1-ETO융합기인100%양성.CD+19t(8;21)AML환자완전완해(CR)솔72%,CD+19반CD+7t(8;21)AML환자CR솔위0,정상핵형CR솔31%.결론 t(8;21)AML환자주요재M2중집중출현,부가염색체이상교다견.CD19표체교고,이CD7표체겁저,CD34、CD117고표체,저사항원적표체가능여핵형밀절상관.CD+19시예후량호적지표,단동시출현CD+7,칙예후불량.
Objective To study the significance of morphologic, immunophenotype, cytogenetic features, molecular biology (MICM) and prognosis of t (8;21) acute myeloid leukemia (AML) patients.Methods Morphological, FAB subtypes, flow cytometric immunophenotyping, G-binding technique and RTPCR were performed in 70 AML patients with t (8;21) and AML1-ETO fusion transcripts as compared with normal karyotype 70 AML patients. Results In 70 AML patients with t(8;21), 1 case of M1, 64 cases of M2, 3cases of M4 and 2 cases of ambiguity AL according to FAB classification. The CD13, CD33, CD34 and CD117expression were higher, meanwhile CD19 was positive in 40 %, CD15 was 11%, CD11b was 10 % and CD7 was 7 %. Cytogenetically, 50 % cases had additional chromosomal abnormalities, and main associated recurrent additional abnormalities were loss of a sex chromosome, 9q- and hyperdiploid. AML1/ETO fusion gene transcripts were detected in all 70 AML patients with t(8;21) by RT-PCR. CR rate of t(8;21) AML with CD19were 72 %, t(8;21) AML with CD19 and CD7 were 0; in normal karyotype AML were 31%. Conclusion The t(8;21) is the characteristic chromosome abnormality of M2. In the t(8;21), CD19, CD34 and CD117 expression are high, while CD7 are low. These antigen expression in t(8;21) AML closely correlated with karyotype. CD19 is a marker of good prognosis, but CD7 is a marker of low CR.