单体核型成人急性髓系白血病临床特征及预后分析  

Monosomal karyotype among adult acute myeloid leukemia： clinical characteristic and prognostic analysis

作　　者：冯茹[1] 刘辉[1] 常乃柏[1] 范云[1] 李江涛[1] 张野坪[1] 程玮[1] 王海飞[1] 田园[1] 裴蕾[1] 宁尚勇[1] 邢宝利[1] 许小东[1] 

机构地区：[1]卫生部北京医院血液科,北京100730

出　　处：《中华血液学杂志》2014年第5期393-396,共4页Chinese Journal of Hematology

基　　金：卫生部北京医院博士启动基金（BJ-2012-17）

摘　　要：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.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.

关 键 词：白血病 髓样 急性 细胞遗传学分析 预后 染色单体 

分 类 号：R733.71[医药卫生—肿瘤]