515例急性髓系白血病患者年龄特异的细胞遗传学分析  

Analysis of age-specific cytogenetic changes among 515 patients with acute myeloid leukemia

作　　者：刘林 徐欢[1] 陈志妹[1] 楼基余[1] 王焕萍[1] 金洁[1] Liu Lin;Xu Huan;Chen Zhimei;Lou Jiyu;Wang Huanping;Jin Jie(Department o/Hematology,the First Affiliated Hospital of Zhejiang University College of Medic ine,Hangzhou,Zhejiang 310003,China)

机构地区：[1]浙江大学医学院附属第一医院血液科,杭州310003

出　　处：《中华医学遗传学杂志》2019年第6期552-555,共4页Chinese Journal of Medical Genetics

基　　金：国家自然科学基金(81400080).

摘　　要：目的 探讨不同年龄急性髓系白血病(acute myeloid leukemia,AML)患者的细胞遗传学特征及临床预后.方法 采用骨髓短期培养和R显带技术分析515例AML患者染色体核型,同时结合FAB分型和基因检测,分析不同年龄组的细胞遗传学特征及预后.结果 515例AML患者异常克隆率为54.6%,骨髓增生综合征(myelodysplastic syndromes,MDS)继发AML的异常克隆率及预后不良核型比例高于原发AML(P=0.027,P<0.01).不同年龄组结构异常率及染色体预后良好核型所占比例的差异有统计学意义(P=0.026,P=0.004).不同FAB分型的染色体异常克隆率的差异有统计学意义(P<0.01).非急性早幼粒细胞白血病(acute promyelocytic leukemia,APL) AML患者中,WT1基因表达量影响预后.染色体核型预后不良组的生存率低于预后良好组(P=0.015).≥60岁组的生存率低于≤30岁组和31~59岁组(P<0.01,P<0.01).结论 不同年龄组染色体核型有不同的年龄分布特征,≥60岁和染色体预后不良核型患者的生存率低;MDS继发的AML患者预后不良.Objective To explore cytogenetic changes and prognosis of patients with acute myeloid leukemia(AML)from different age groups.Methods The karyotypes of 515 AML patients were analyzed by using short term culture of bone marrow cells and R-banding technique.Combined with FAB typing and genetic testing,the cytogenetic changes and prognosis of different age groups were analyzed.Results The abnormal cloning rate was 54.6%among the 515 patients.The abnormal cloning rate and adverse risk karyotype proportion of those with myeloproliferative syndromes(MDS)and secondary AML were higher than those with de novo AML(P=0.027;P<0.01).A significant difference was found in the occurrence of structural abnormalities and proportion of favorable risk karyotypes among different age groups(P=0.026;P=0.004).And there was also a significant difference in the abnormal cloning rates between different FAB types(P<0.01).In those with non-acute promyelocytic leukemia(APL),the expression level of WT1 gene may affect the prognosis.The survival rate of patients with karyotypes of adverse risk was lower than those with karyotypes of favorable risk(P=0.015).The survival rate of the≥60-year-old group was lower than the≤30-year old and 31-59-year-old groups(P<0.01,P<0.01).Conclusion The karyotypes of AML patients have different age distribution characteristics.The survival rate of≥60-years old group and karyotype of poor prognosis is low.Patients with MDS with secondary AML have a poor prognosis.

关 键 词：急性髓性白血病 细胞遗传学 年龄 预后 

分 类 号：R73[医药卫生—肿瘤]