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成人费城染色体阳性急性淋巴细胞白血病中额外染色体异常及其预后意义:化疗中使用或不使用伊马替尼的情况

Additional chromosomal abnormalities and their prognostic significance in adult Philadelphia-positive acute lymphoblastic leukemia: with or without imatinib in chemotherapy.

作者信息

Li Yenan, Qiu Lugui, Zou Dehui, Zhao Yaozhong, Mi Yingchang, Wang Jianxiang

机构信息

State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 288 Nanjing Road, Tianjin, People's Republic of China.

出版信息

Ann Hematol. 2009 Nov;88(11):1069-77. doi: 10.1007/s00277-009-0720-z. Epub 2009 Mar 10.

Abstract

The study analyzed the characteristics and prognostic significance of additional chromosomal abnormalities in 110 Chinese adults with Philadelphia chromosome-positive (Ph-positive) acute lymphoblastic leukemia (ALL). Secondary aberrations were present in 60.9% of the cases. All chromosomes were involved in secondary aberrations, and chromosomes 9, 7, 21, 18, and 14 were most frequently abnormal. Fifty of 110 patients (45.5%) had at least one normal metaphase cell in their chromosome preparations at diagnosis. Patients with additional aberrations had shorter disease-free survival (DFS) and overall survival (OS) in chemotherapy combined with imatinib (ICT) group and only shorter DFS in conventional chemotherapy (CT) group. The existence of normal metaphase cells was associated with a superior survival in CT group, but not in ICT group. Patients with loss of chromosomes 7, 7p, 9, and 9p had inferior outcome compared to patients with other secondary aberrations and those without secondary aberrations, in both CT and ICT group.

摘要

该研究分析了110例中国成人费城染色体阳性(Ph阳性)急性淋巴细胞白血病(ALL)患者额外染色体异常的特征及预后意义。60.9%的病例存在继发性畸变。所有染色体均参与继发性畸变,其中9号、7号、21号、18号和14号染色体最常出现异常。110例患者中有50例(45.5%)在诊断时的染色体标本中至少有一个正常中期细胞。在化疗联合伊马替尼(ICT)组中,存在额外畸变的患者无病生存期(DFS)和总生存期(OS)较短,而在传统化疗(CT)组中只有DFS较短。正常中期细胞的存在与CT组较好的生存率相关,但与ICT组无关。在CT组和ICT组中,与有其他继发性畸变的患者及无继发性畸变的患者相比,7号、7p、9号和9p染色体缺失的患者预后较差。

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