中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2009年
6期
481-484
,共4页
李业楠%邹德慧%顾敏%秘营昌%王建祥%邱录贵
李業楠%鄒德慧%顧敏%祕營昌%王建祥%邱錄貴
리업남%추덕혜%고민%비영창%왕건상%구록귀
白血病%费城染色体%预后%融合蛋白质类,bcr-abl
白血病%費城染色體%預後%融閤蛋白質類,bcr-abl
백혈병%비성염색체%예후%융합단백질류,bcr-abl
Leukemia%Philadelphia chromosome%Prognosis%Fusion proteins,bcr-abl
目的 比较成人Ph+急性淋巴细胞白血病(ALL)不同融合基因转录本临床特征的差异,并探讨其与预后的关系.方法 回顾性分析1996年1月至2007年12月我院诊断为Ph+ALL患者(年龄≥15岁)的资料,比较两个BCR-ABL转录本组间的临床特征,探讨两组患者预后的差异.结果 (1)106例患者中位年龄34岁,中位白细胞数28.5×109/L.p190组67例,p210组35例,p210组较p190组中位年龄偏大(40岁、31岁,P=0.002),初诊血小板数高(49.5×109/L、31.5×109/L,P=0.012),中、重度脾大的发生率高(48.6%、25.4%,P=0.019).(2)两组患者完全缓解(CR)率分别为92.2%(59/64)和93.9%(31/33).(3)p190组中位总生存(OS)和中位无复发生存(RFS)分别为13个月和10个月;p210组中位OS和RFS分别为15个月和10个月.两组之间比较差异无统计学意义(P>0.05).结论 成人Ph+ALL中BCR-ABL以p190表达为主;p210患者较p190具有年龄偏大,初诊血小板数偏高,中、重度脾大发生率高的特点;两组在CR率、RFS和OS上无明显差异.
目的 比較成人Ph+急性淋巴細胞白血病(ALL)不同融閤基因轉錄本臨床特徵的差異,併探討其與預後的關繫.方法 迴顧性分析1996年1月至2007年12月我院診斷為Ph+ALL患者(年齡≥15歲)的資料,比較兩箇BCR-ABL轉錄本組間的臨床特徵,探討兩組患者預後的差異.結果 (1)106例患者中位年齡34歲,中位白細胞數28.5×109/L.p190組67例,p210組35例,p210組較p190組中位年齡偏大(40歲、31歲,P=0.002),初診血小闆數高(49.5×109/L、31.5×109/L,P=0.012),中、重度脾大的髮生率高(48.6%、25.4%,P=0.019).(2)兩組患者完全緩解(CR)率分彆為92.2%(59/64)和93.9%(31/33).(3)p190組中位總生存(OS)和中位無複髮生存(RFS)分彆為13箇月和10箇月;p210組中位OS和RFS分彆為15箇月和10箇月.兩組之間比較差異無統計學意義(P>0.05).結論 成人Ph+ALL中BCR-ABL以p190錶達為主;p210患者較p190具有年齡偏大,初診血小闆數偏高,中、重度脾大髮生率高的特點;兩組在CR率、RFS和OS上無明顯差異.
목적 비교성인Ph+급성림파세포백혈병(ALL)불동융합기인전록본림상특정적차이,병탐토기여예후적관계.방법 회고성분석1996년1월지2007년12월아원진단위Ph+ALL환자(년령≥15세)적자료,비교량개BCR-ABL전록본조간적림상특정,탐토량조환자예후적차이.결과 (1)106례환자중위년령34세,중위백세포수28.5×109/L.p190조67례,p210조35례,p210조교p190조중위년령편대(40세、31세,P=0.002),초진혈소판수고(49.5×109/L、31.5×109/L,P=0.012),중、중도비대적발생솔고(48.6%、25.4%,P=0.019).(2)량조환자완전완해(CR)솔분별위92.2%(59/64)화93.9%(31/33).(3)p190조중위총생존(OS)화중위무복발생존(RFS)분별위13개월화10개월;p210조중위OS화RFS분별위15개월화10개월.량조지간비교차이무통계학의의(P>0.05).결론 성인Ph+ALL중BCR-ABL이p190표체위주;p210환자교p190구유년령편대,초진혈소판수편고,중、중도비대발생솔고적특점;량조재CR솔、RFS화OS상무명현차이.
Objective To investigate the difference of clinical characteristics and outcomes between different isoforms of BCR/ABL in adults with Philadelphia-positive acute lymphoblastic leukemia (ALL).Methods The data of 106 adults with Ph+ALL diagnosed in our hospital from January 1, 1996 to December 31, 2007 were reviewed. The difference of clinical characteristics between different subgroups of BCR/ABL was compared and their relation with outcomes was studied. Results The median age of the 106 patients was 34 years and the median white blood cell count at baseline was 28. 5 × 109/L. Comparative analysis demonstrated that patients in p210 group had an older age, higher blood platelet count (BPC) and more frequent occurrence of splenomegaly. Referring to the outcomes, the complete remission (CR) rate of the two groups were 92. 2% and 93.9%, respectively. The median overall survival (OS) and relapse free survival (RFS) in p190 group were 13 months and 10 months, the 1,3-year estimated OS were (54. 7±6. 7)% and (5.5±5.2)%, and the 1,3-year estimated RFS were (40. 2±6. 8)% and (7. 8±6. 7)%,while in p210 group, the median OS and RFS were 15 months and 10 months, respectively, the 1,3-year estimated OS were (65.8±8. 9)% and (14. 5±7.4)%, and the 1,3-year estimated RFS were (48. 3±9. 4)% and (12. 9±7. 7)%. All of the above data had no statistic significance between the two groups.Conclusion Majority of the adults with Ph+ALL is p190 positive and patients with p210 have older age, higher BPC and more frequent occurrence of splenomegaly, while there is no significant difference between p190 group and p210 group in CR rate, RFS and OS.