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成人继发性急性髓系白血病(AML)的细胞遗传学结果:预后良好和不良染色体畸变的频率与成人原发性AML无差异。

Cytogenetic findings in adult secondary acute myeloid leukemia (AML): frequency of favorable and adverse chromosomal aberrations do not differ from adult de novo AML.

作者信息

Preiss Birgitte S, Bergmann Olav J, Friis Lone S, Sørensen Anne G, Frederiksen Michael, Gadeberg Ole V, Mourits-Andersen Torben, Oestergaard Birthe, Kerndrup Gitte B

机构信息

Department of Pathology, Odense University Hospital, Odense C, Denmark.

出版信息

Cancer Genet Cytogenet. 2010 Oct 15;202(2):108-22. doi: 10.1016/j.cancergencyto.2010.06.013.

Abstract

During a 15-year period, 161 adult patients were diagnosed with secondary acute myeloid leukemia (s-AML) in the region of Southern Denmark. In 73 patients, the AML diagnosis was preceded by myelodysplastic syndrome (MDS-AML), in 31 patients by an antecedent hematologic disease, and in 57 patients by treatment with chemotherapy and/or irradiation (t-AML). Cytogenetic analysis was carried out in 93%, of which 61% had clonal chromosome aberrations. MDS-AML correlated to a normal karyotype (P < 0.001). t-AML correlated to abnormal clones with numerical and structural aberrations (P = 0.03), five or more unrelated aberrations (P = 0.03), marker chromosomes (P = 0.006), abnormal mitoses only (P = 0.01), female sex (P < 0.001), and -7 (P = 0.006). Centromeric breakage correlated to a complex karyotype (P = 0.01). The frequencies of aberrations in s-AML patients were compared with an age-matched group of de novo AML patients diagnosed in the same area and period. In this comparison, s-AML only correlated to -7 (P = 0.02). In 42 patients, we found that MDS patients with an abnormal karyotype were more likely to show cytogenetic evolution during progression to AML than MDS patients with a normal karyotype (P = 0.01). We conclude that population-based cytogenetic studies of adult s-AML and age- and sex-matched de novo AML show comparable distributions of chromosome abnormalities.

摘要

在15年期间,丹麦南部地区有161例成年患者被诊断为继发性急性髓系白血病(s-AML)。其中73例患者在AML诊断之前患有骨髓增生异常综合征(MDS-AML),31例患者有前驱血液系统疾病,57例患者因化疗和/或放疗而发病(t-AML)。93%的患者进行了细胞遗传学分析,其中61%有克隆性染色体异常。MDS-AML与正常核型相关(P<0.001)。t-AML与具有数量和结构异常的异常克隆相关(P=0.03)、与五个或更多不相关的异常相关(P=0.03)、与标记染色体相关(P=0.006)、仅与异常有丝分裂相关(P=0.01)、与女性性别相关(P<0.001)以及与-7相关(P=0.006)。着丝粒断裂与复杂核型相关(P=0.01)。将s-AML患者的异常频率与在同一地区和时期诊断的年龄匹配的初发AML患者组进行比较。在该比较中,s-AML仅与-7相关(P=0.02)。在42例患者中,我们发现核型异常的MDS患者在进展为AML的过程中比核型正常的MDS患者更有可能出现细胞遗传学演变(P=0.01)。我们得出结论,基于人群的成年s-AML以及年龄和性别匹配的初发AML的细胞遗传学研究显示染色体异常的分布具有可比性。

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