Tashiro S, Kyo T, Tanaka K, Oguma N, Hashimoto T, Dohy H, Kamada N
Department of Hematology, Research Institute for Nuclear Medicine and Biology, Hiroshima, Japan.
Cancer. 1992 Dec 15;70(12):2809-15. doi: 10.1002/1097-0142(19921215)70:12<2809::aid-cncr2820701214>3.0.co;2-#.
Some specific chromosome abnormalities for the leukemias have been proven to be associated with the prognosis of acute nonlymphocytic leukemia (ANLL). However, most of these reports included patients treated with different protocols. Therefore, some bias has been involved in the evaluation of the prognostic factors in such reports.
The authors studied the morphologic, cytogenetic, and clinical features of 136 patients (86 males and 50 females) with de novo ANLL treated with the same protocol of intensive induction chemotherapy using multivariate analyses.
Chromosome abnormalities were detected in 62.5% of the patients. The overall complete remission (CR) rate of disease was 85.5% in these patients. More than 90% of the patients with t(8;21) and pseudodiploid abnormalities achieved experienced CR. However, CR rates in the patients with abnormalities of chromosome 5 or 7 were 50%. With multivariate analyses by the type of karyotypic abnormality, CR duration and survival time of the patients with t(8;21) were longer than those of patients with normal karyotype and abnormalities of chromosome 5 or 7. Abnormalities of chromosome 5 or 7 and hyperdiploid were associated with poor prognosis. Older age and lower platelet counts also were factors contributing to shorter survival times. With the analysis with French-American-British (FAB) classification, only hypoplastic leukemia was a poor prognostic factor.
These data suggest that cytogenetic analyses plays an important role in estimating the prognosis of patients treated with intensive induction chemotherapy.
已证实白血病的某些特定染色体异常与急性非淋巴细胞白血病（ANLL）的预后相关。然而，这些报告中的大多数纳入了接受不同治疗方案的患者。因此，此类报告在评估预后因素时存在一些偏差。
作者采用多变量分析研究了136例初发ANLL患者（86例男性，50例女性）的形态学、细胞遗传学和临床特征，这些患者均接受相同方案的强化诱导化疗。
62.5%的患者检测到染色体异常。这些患者的疾病总体完全缓解（CR）率为85.5%。超过90%的t(8;21)和假二倍体异常患者实现了CR。然而，染色体5或7异常的患者CR率为50%。通过对核型异常类型进行多变量分析，t(8;21)患者的CR持续时间和生存时间长于核型正常以及染色体5或7异常的患者。染色体5或7异常以及超二倍体与预后不良相关。年龄较大和血小板计数较低也是导致生存时间较短的因素。采用法国-美国-英国（FAB）分类分析，只有低增生性白血病是不良预后因素。
这些数据表明细胞遗传学分析在评估接受强化诱导化疗患者的预后中起重要作用。
