Roberson Jessica R, Onciu Mihaela, Pounds Stanley, Rubnitz Jeffrey E, Pui Ching-Hon, Razzouk Bassem I
Department of Hematology-Oncology, St. Jude Children's Research Hospital, and the University of Tennessee College of Medicine, Memphis, Tennessee, USA.
Pediatr Blood Cancer. 2008 Mar;50(3):542-8. doi: 10.1002/pbc.21258.
The percentage of myeloperoxidase (MPO)-positive blast cells is associated with prognosis in adult acute myeloid leukemia (AML), but this association is unsubstantiated in pediatric AML.
We retrospectively compared cytochemical MPO results with outcome in 154 patients younger than 21 years treated on three consecutive institutional protocols for newly diagnosed AML (1987-2001). Patients with FAB M0 and M7 AML (no MPO expression) or M3 AML (100% MPO expression) and Down's syndrome were excluded.
Median MPO expression was higher in FAB M2 subtype than in other subtypes (P < 0.0001) and differed significantly across cytogenetic risk groups (P = 0.002) with highest MPO expression among those with favorable karyotypes. The percentage of MPO-positive blasts was not significantly associated with the probability of complete remission (P = 0.97), event-free survival (P = 0.72), or survival (P = 0.76) in multivariate analyses that accounted for age, FAB subtype, presenting WBC count, cytogenetic and protocol treatment risk group. In analysis limited to patients with intermediate-risk cytogenetics, higher MPO expression appeared to be associated with improved EFS (P = 0.06) but was not associated with remission induction rate (P = 0.16) or overall survival (P = 0.38).
The percentage of MPO-positive blast cells is related to FAB subtype in pediatric AML but has limited prognostic relevance.
髓过氧化物酶（MPO）阳性原始细胞的百分比与成人急性髓系白血病（AML）的预后相关，但在儿童AML中这种关联尚未得到证实。
我们回顾性比较了154例年龄小于21岁、按照三个连续机构方案治疗的新诊断AML患者（1987 - 2001年）的细胞化学MPO结果与预后情况。排除了FAB M0和M7 AML（无MPO表达）或M3 AML（100% MPO表达）以及唐氏综合征患者。
FAB M2亚型的MPO表达中位数高于其他亚型（P < 0.0001），并且在细胞遗传学风险组之间存在显著差异（P = 0.002），核型良好的患者中MPO表达最高。在考虑年龄、FAB亚型、初诊时白细胞计数、细胞遗传学和方案治疗风险组的多变量分析中，MPO阳性原始细胞的百分比与完全缓解概率（P = 0.97）、无事件生存期（P = 0.72）或生存期（P = 0.76）均无显著关联。在仅限于中等风险细胞遗传学患者的分析中，较高的MPO表达似乎与改善的无事件生存期相关（P = 0.06），但与缓解诱导率（P = 0.16）或总生存期（P = 0.38）无关。
儿童AML中MPO阳性原始细胞的百分比与FAB亚型相关，但预后相关性有限。
