中华血液学杂志
中華血液學雜誌
중화혈액학잡지
Chinese Journal of Hematology
2014年
11期
970-973
,共4页
程文秀%孙爱宁%陈苏宁%仇惠英%尹佳%平娜娜%王谦%吴德沛
程文秀%孫愛寧%陳囌寧%仇惠英%尹佳%平娜娜%王謙%吳德沛
정문수%손애저%진소저%구혜영%윤가%평나나%왕겸%오덕패
白血病,幼红细胞,急性%疾病特征%预后
白血病,幼紅細胞,急性%疾病特徵%預後
백혈병,유홍세포,급성%질병특정%예후
Leukemia,erythroblastic,acute%Disease attributes%Prognosis
目的 描述急性红白血病(AEL)患者的生物学特征,探讨其与预后的关系.方法 回顾性分析2003至2013年6月167例初治AEL患者的形态学、免疫学、分子生物学及细胞遗传学检测资料,采用Kaplan-Meier方法分析预后影响因素.结果 经流式细胞术检测显示,AEL高表达CD13(96.1％)、CD33(95.1％)、CD117(87.4％)、CD34(79.6％).染色体异常核型检出率为37.8％(56/148),复杂异常为18.2％(27/148).异常核型中累及较多的为3、5、7、8、20号染色体.+8最常见(35.7％),其次是5q-(17.9％).突变检测显示,AEL患者CEBPA突变率为44.0％(11/25),NPM1突变率为15.4％(4/26).AEL患者初次诱导缓解率为56.6％(30/53),骨髓增生异常综合征转化AEL缓解率为33.3％(4/12).生存分析显示,女性患者总体生存(OS)率优于男性(P=0.047),异基因造血干细胞移植组OS率优于化疗组(P=0.000).13～ 39岁组AEL患者OS率最高,40～ 49岁组次之,＞50岁组最差(P=0.024).结论 AEL具有独特的生物学特征,异基因造血干细胞移植能显著改善患者的预后.
目的 描述急性紅白血病(AEL)患者的生物學特徵,探討其與預後的關繫.方法 迴顧性分析2003至2013年6月167例初治AEL患者的形態學、免疫學、分子生物學及細胞遺傳學檢測資料,採用Kaplan-Meier方法分析預後影響因素.結果 經流式細胞術檢測顯示,AEL高錶達CD13(96.1％)、CD33(95.1％)、CD117(87.4％)、CD34(79.6％).染色體異常覈型檢齣率為37.8％(56/148),複雜異常為18.2％(27/148).異常覈型中纍及較多的為3、5、7、8、20號染色體.+8最常見(35.7％),其次是5q-(17.9％).突變檢測顯示,AEL患者CEBPA突變率為44.0％(11/25),NPM1突變率為15.4％(4/26).AEL患者初次誘導緩解率為56.6％(30/53),骨髓增生異常綜閤徵轉化AEL緩解率為33.3％(4/12).生存分析顯示,女性患者總體生存(OS)率優于男性(P=0.047),異基因造血榦細胞移植組OS率優于化療組(P=0.000).13～ 39歲組AEL患者OS率最高,40～ 49歲組次之,＞50歲組最差(P=0.024).結論 AEL具有獨特的生物學特徵,異基因造血榦細胞移植能顯著改善患者的預後.
목적 묘술급성홍백혈병(AEL)환자적생물학특정,탐토기여예후적관계.방법 회고성분석2003지2013년6월167례초치AEL환자적형태학、면역학、분자생물학급세포유전학검측자료,채용Kaplan-Meier방법분석예후영향인소.결과 경류식세포술검측현시,AEL고표체CD13(96.1％)、CD33(95.1％)、CD117(87.4％)、CD34(79.6％).염색체이상핵형검출솔위37.8％(56/148),복잡이상위18.2％(27/148).이상핵형중루급교다적위3、5、7、8、20호염색체.+8최상견(35.7％),기차시5q-(17.9％).돌변검측현시,AEL환자CEBPA돌변솔위44.0％(11/25),NPM1돌변솔위15.4％(4/26).AEL환자초차유도완해솔위56.6％(30/53),골수증생이상종합정전화AEL완해솔위33.3％(4/12).생존분석현시,녀성환자총체생존(OS)솔우우남성(P=0.047),이기인조혈간세포이식조OS솔우우화료조(P=0.000).13～ 39세조AEL환자OS솔최고,40～ 49세조차지,＞50세조최차(P=0.024).결론 AEL구유독특적생물학특정,이기인조혈간세포이식능현저개선환자적예후.
Objective To observe the biological characteristic and the prognoses in patients with acute erythroleukemia (AEL).Methods The results of 167 patients with newly diagnosed AEL,from January 2003 and June 2013 in the First Affiliated Hospital of Soochow University,were reviewed by MICM.Results Flow cytometry analysis indicated that CD13 (96.1％),CD33 (95.1％),CD117(87.4％)and CD34 (79.4％) were highly expressed in AEL.56 of 148 (37.8％) AEL patients had a variety of cytogenetic abnormalities,27 of 148 (18.2％) patients were complex karyotype (abnormalities involving 3 or more chromosomes),the abnormalities of chromosomes 3,5,7 and 8 were more frequently involved andthe most common one was +8,accounting for 35.7％ of all abnormal karyotype,followed by 5q-(17.9％).Mutation analysis showed CEBPA mutation ratio of AEL patients was 44.0％ (11/25),that of NPM1 as 15.4％ (4/26).Initial induced remission rate of AEL was 56.6％ (30/53),compared by 33.3％ (4/12) of MDSM6.Survival analysis showed that the overall survival in female was better than that in male (P=0.047).The overall survival time of transplantation group is significantly longer than chemotherapy group (P=0.000).The OS of 13-39 years old group was the best,40-49 years old group took second place,＞50 years old group appeared to be the worst.Conclusion AEL had its own unique biological features,and allogeneic hematopoietic stem cell transplantation could significantly improve its poor prognosis.
