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在一名急性早幼粒细胞白血病患儿中,ider(17)(q10)t(15;17)与复发及不良预后相关。

ider(17)(q10)t(15;17) associated with relapse and poor prognosis in a pediatric patient with acute promyelocytic leukemia.

作者信息

Kim Min Jin, Yoon Hoi Soo, Cho Sun Young, Lee Hee Joo, Suh Jin-Tae, Lee Juhie, Yoon Hwi-Joong, Lee Woo-In, Park Tae Sung

机构信息

Department of Laboratory Medicine, Kyung Hee University, Dongdaemun-gu, Seoul, Korea.

出版信息

Cancer Genet Cytogenet. 2010 Sep;201(2):116-21. doi: 10.1016/j.cancergencyto.2010.05.007.

Abstract

Although acute promyelocytic leukemia (APL) has been regarded as a serious medical emergency associated with disseminated intravascular coagulopathy or subsequent mortality, it is now considered a curable leukemia that is particularly sensitive to treatment with all-trans retinoic acid combined with chemotherapy. However, it is not clear whether additional chromosomal abnormalities in APL patients directly influence the prognosis or treatment response. ider(17)(q10)t(15;17)(q22;q21) has mostly been reported in adult APL patients, and only three cases of pediatric APL associated with ider(17)(q10)t(15;17) showing poor prognosis have been described in the literature. Here, we report the close follow-up (clinical and laboratory) data of a pediatric APL case associated with ider(17)(q10)t(15;17). This patient had APL relapse from the same clone 15 months after morphological remission. Furthermore, despite subsequent chemotherapy, the patient died 16 months after the initial APL diagnosis. Although based on a limited amount of data (four pediatric APL cases), such results in pediatric APL patients may provide important insight into the relationship between ider(17)(q10)t(15;17) and poor prognosis. However, further well-designed case-control studies are necessary to determine the treatment response and prognosis in pediatric or adult APL patients with ider(17)(q10)t(15;17).

摘要

尽管急性早幼粒细胞白血病(APL)一直被视为与弥散性血管内凝血或后续死亡率相关的严重医疗急症,但现在它被认为是一种可治愈的白血病,对全反式维甲酸联合化疗特别敏感。然而,APL患者额外的染色体异常是否直接影响预后或治疗反应尚不清楚。ider(17)(q10)t(15;17)(q22;q21)大多在成年APL患者中报道,文献中仅描述了3例与ider(17)(q10)t(15;17)相关的预后不良的儿童APL病例。在此,我们报告1例与ider(17)(q10)t(15;17)相关的儿童APL病例的密切随访(临床和实验室)数据。该患者在形态学缓解15个月后出现同一克隆的APL复发。此外,尽管随后进行了化疗,患者在初次APL诊断后16个月死亡。尽管基于有限的数据量(4例儿童APL病例),但儿童APL患者的这些结果可能为ider(17)(q10)t(15;17)与预后不良之间的关系提供重要见解。然而,需要进一步设计良好的病例对照研究来确定伴有ider(17)(q10)t(15;17)的儿童或成年APL患者的治疗反应和预后。

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