伴8号染色体三体的急性白血病特征及预后分析  

Characteristics and Prognosis Analysis of Acute Leukemia with Trisomy 8

作　　者：邵晶璇[1] 阳洁[1] 陈宏[1] 

机构地区：[1]广西医科大学第四附属医院血液科,广西柳州545005

出　　处：《系统医学》2017年第12期105-107,共3页Systems Medicine

基　　金：广西壮族自治区卫生厅资助项目(Z2001479);柳州市科技局资助项目(2011J032015)

摘　　要：目的探讨伴8号染色体三体(+8)的急性白血病的临床特征及预后因素。方法回顾分析2007年1月—2016年12月在该院住院的60例伴+8染色体异常的急性白血病患者临床特征,包括性别、年龄、血象、骨髓幼稚细胞、亚型、染色体、基因突变、治疗方法等,并分析其预后影响因素。结果 60例患者中,男性31例,女性29例,平均中位年龄42岁,60例病例中急性髓系白血病(AML)有48例,其中M2 10例,M3 2例,M5 22例,M4 14例。急性淋巴细胞白血病(ALL)有12例,同时合并Ph+有8例,Ph-4例。30例行基因突变的病例中有基因突变的20例:FLT3-ITD 8例,C-kit 5例,NPM1 3例,CEBPA 4例。截止到随访日期,35例死亡,25例存活,存活病例中有8例行异基因造血干细胞移植。2年OS为60%,5年存活50%。中位生存时间70个月(3~125月),其中单纯+8核型中位生存时间80月(5~125月),非单纯+8核型中位生存时间56月(3~125月)。结论性别、年龄、初诊时血红蛋白、血小板数、骨髓幼稚细胞比例等因素与预后无相关性。非单纯+8核型、初诊时白细胞数≥20×10~9/L是影响患者OS的不良预后因素,异基因造血干细胞移植是提高OS的预后良好因素。Objective This paper tries to investigate clinical characteristics and prognosis of acute leukemia with trisomy 8（＋8）. Methods The clinical features of 60 patients with acute leukemia with ＋8 chromosome abnormalities in this hospital from January 2007 to December 2016 were analyzed retrospectively, including gender, age, hemogram,bone marrow blasts, subtype, chromosome, gene mutation, treatment methods, and the prognostic factors were analyzed.Results Among the 60 patients, 31 cases were male, 29 cases were female, with the average median age of 42 years old. There were 48 cases of acute myeloid leukemia（AML）, including 10 cases of M2, 2 cases of M3, 22 cases of M5,14 cases of M4. Acute lymphocytic leukemia（ALL） was 12 cases, and 8 cases of Ph＋, 4 cases of Ph-. There were 20 cases of gene mutation in the total 30 cases： 8 cases of FLT3-ITD, 5 cases of C-kit, 3 cases of NPM1, 4 cases of CEBPA. By the end of the follow-up period, 35 cases died, 25 cases survived, and 8 cases accepted allo-HSCT. 2years OS was 60%, 5 years survival rate was 50%. Median survival time was 70 months（3-125 months）, including simple ＋8 karyotype median survival time was 80 months（5-125 months）, non-simple ＋8 karyotype median survival time was 56 months（3-125 months）. Conclusion Sex, age, the number of hemoglobin, platelet count, bone marrow immature cells and other factors were not correlated with prognosis. Non-simple ＋8 karyotype, newly diagnosed white blood cellnumber ≥ 20 × 10~9/L is a poor prognostic factor in patients with OS, allogeneic hematopoietic stem cell transplantation is a good factor to improve the prognosis of

关 键 词：急性白血病 染色体 8三体 预后 

分 类 号：R733.7[医药卫生—肿瘤]