CAJ | 학술논문

目的探讨单体核型(MK)成人急性髓系白血病(AML)的临床及预后特征.方法回顾性分析2000年10月至2012年12月新诊断的45例MK+患者的临床、染色体核型及预后特征.结果 237例新诊断并行染色体核型分析的AML患者中有45例(19.0％)为MK,其中男28例(62.2％),女17例(37.8％),中位年龄58(18～91)岁.MK+患者最常出现的染色单体为-5(31.1％)和-7(17.8％).AML患者MK发生率随年龄增长而增加,＜30岁、30～59岁和≥60岁AML患者中MK发生率分别为11.5％、17.7％和22.4％.MK+和MK-组患者的性别、FAB亚型分布差异均无统计学意义(P=0.545、0.239).MK+ AML患者的中位生存期为6.5(0.6～107.3)个月,5年累积总生存率为5.2％.45例MK+AML患者中有43例(95.6％)同时符合复杂核型(CK);2例不符合复杂核型(CK-)的患者均未获得完全缓解(CR),在6个月内死亡.在192例MK-AML患者中有12例为CK,中位生存期为18.5(5.5～133.0)个月;MK+CK+与MK-CK+组患者CR率、总生存率差异均有统计学意义(P值均＜0.05).结论 MK在AML患者的检出率随年龄增长而增加,MK与AML患者较低的CR率及总生存率相关.
목적 탐토단체핵형(MK)성인급성수계백혈병(AML)적림상급예후특정.방법 회고성분석2000년10월지2012년12월신진단적45례MK+환자적림상、염색체핵형급예후특정.결과 237례신진단병행염색체핵형분석적AML환자중유45례(19.0％)위MK,기중남28례(62.2％),녀17례(37.8％),중위년령58(18～91)세.MK+환자최상출현적염색단체위-5(31.1％)화-7(17.8％).AML환자MK발생솔수년령증장이증가,＜30세、30～59세화≥60세AML환자중MK발생솔분별위11.5％、17.7％화22.4％.MK+화MK-조환자적성별、FAB아형분포차이균무통계학의의(P=0.545、0.239).MK+ AML환자적중위생존기위6.5(0.6～107.3)개월,5년루적총생존솔위5.2％.45례MK+AML환자중유43례(95.6％)동시부합복잡핵형(CK);2례불부합복잡핵형(CK-)적환자균미획득완전완해(CR),재6개월내사망.재192례MK-AML환자중유12례위CK,중위생존기위18.5(5.5～133.0)개월;MK+CK+여MK-CK+조환자CR솔、총생존솔차이균유통계학의의(P치균＜0.05).결론 MK재AML환자적검출솔수년령증장이증가,MK여AML환자교저적CR솔급총생존솔상관.
Objective To explore the clinical characteristics and prognostic value of monosomal karyotype (MK) patients in adult acute myeloid leukemia (AML).Methods We retrospectively studied 45 patients of MK+ in newly-diagnosed adult AML in our center from Oct 2000 to Dec 2012.Clinical characteristics,cytogenetic data and prognostic features were analyzed in the cohort of MK + patients.Results MK was found in 45 patients (19.0％) of 237 newly-diagnosed adult AML with cytogenetic data available at diagnoses.Among these 45 cases,there were 28 male (62.2％) and 17 female (37.8％).Median age of MK + patients at diagnose was 58 (18-91) years old.The presence of-5 (31.1％) and-7 (17.8％) were the most common chromatid among MK+ AML patients.MK was much more prevalent among elderly patients.Among AML patients,the proportions of MK+ patients younger than 30,30 to 59 and older than 60 years old groups were 11.5％,17.7％ and 22.4％,respectively There was no difference between MK+ and MK-patients in gender distribution (P=0.545).There was also no difference between MK+ and MK-patients in the distribution of FAB castigation (P=0.239).Median survival of MK+ AML patients was 6.5 months.Cumulative 5-year overall survival (OS) of was 5.2％.Forty-three MK+ patients (43/45,95.6％) also had a complex karyotype (CK).Two cases that did not meet the CK had not achieved complete remission (CR),and died within 6 months.There were 12 patients who were CK+ in 192 MK-patients.The differences of OS and CR rates between MK+ CK+ patients and MK CK+ were statistically significant (P＜0.05).Conclusions The increased detection rate of MK with age was associated with lower CR and OS in AML patients.