PML/RARα亚型与急性早幼粒细胞白血病患者临床特点及预后分析  

Analysis of PML/RARα Subtypes and Clinical Characteristics and Prognosis of Patients with Acute Promyelocytic Leukemia

作　　者：陈伟伟[1] 潘玉 孙福金 夏天 程相山 CHEN Weiwei;PAN Yu;SUN Fujin;XIA Tian;CHENG Xiangshan(Department of Hematology,Heze Municipal Hospital,Heze,Shandong Province,274000 China)

机构地区：[1]菏泽市立医院血液科,山东菏泽274000

出　　处：《系统医学》2022年第16期27-31,共5页Systems Medicine

摘　　要：目的 探讨PML/RARα亚型与急性早幼粒细胞白血病(acute promyelocytic leukemia, APL)患者临床特点及预后。方法 选择2014年3月—2019年3月菏泽市立医院收治的APL初诊患者117例为研究对象,根据PML/RARα基因分型分为L型患者63例、V型患者15例、S型患者39例。比较PML/RARα亚型患者临床特征、治疗反应情况及随访疾病无进展生存情况。结果 PML/RARαL型、V型、S型患者WBC[(6.28±2.10)×10^(9)/L vs(28.39±8.30)×10^(9)/L vs(15.40±4.32)×10^(9)/L]、Fib[(1.98±0.42)g/L vs(1.60±0.37)g/L vs(0.97±0.22)g/L]水平比较,差异有统计学意义(F=191.423、7.735,P<0.001)。免疫表型分析结果显示,S型患者CD34阳性表达率显著高于L型和V型,差异有统计学意义(P<0.05)。PML/RARα不同亚型患者危险度封层结果显示,S型患者高危比例较高,3组比较差异有统计学意义(P<0.05)。生存情况分析显示,L型、V型患者无进展生存情况显著优于S型患者,差异有统计学意义(P<0.05)。结论 PML/RARα不同亚型患者临床特征有所不同,其中S型患者纤维蛋白原水平低、CD34阳性表达率高、危险度分层高危患者比例高,S型患者临床预后更差。Objective To investigate the PML/RARα subtypes and the clinical characteristics and prognosis of patients with acute promyelocytic leukemia(APL).Methods A total of 117 newly diagnosed APL patients admitted to Heze Municipal Hospital from March 2014 to March 2019 were selected as the research objects. According to PML/RARα genotyping divided into the L type patients 63 cases, V type patients 15 cases, and S type patients 39 cases.The clinical characteristics, treatment response and follow-up disease progression-free survival of patients with PML/RARα subtype were compared.Results WBC [(6.28±2.10)×10^(9)/L vs(28.39±8.30)×10^(9)/L vs(15.40±4.32)×10^(9)/L] and Fib [(1.98±0.42)g/L vs(1.60±0.37)g/L vs(0.97±0.22)g/L] levels of PML/RARα type L,Vand S compared, the difference was statistically significant(F=191.423, 7.735, P<0.001). The results of immunophenotype analysis showed that the positive expression rate of CD34 in patients with S type was significantly higher than that in L type and V type,and the difference was statistically significant(P<0.05). The results of the risk seal of patients with different subtypes of PML/RARα showed that the high risk ratio of patients with S type was higher, and the difference was statistically significant among the three groups(P<0.05). Survival analysis showed that the progression-free survival of L-type and V-type patients was significantly better than that of S-type patients, and the difference was statistically significant(P<0.05).Conclusion The clinical characteristics of patients with different subtypes of PML/RARα are different. Among them, patients with type S have low fibrinogen level, high CD34 positive expression rate, and a high proportion of patients with high risk stratification. The clinical prognosis of patients with S type is worse.

关 键 词：PML/RARα亚型 急性早幼粒细胞白血病 临床特点 预后 

分 类 号：R521[医药卫生—内科学]