Numata Ayumi, Fujimaki Katsumichi, Aoshima Tomohiro, Onizuka Makoto, Hagihara Maki, Miyazaki Koji, Fujita Hiroyuki, Sakai Rika, Machida Shinichiro, Tanaka Eri, Nakajima Yuki, Hattori Yukako, Tanaka Masatsugu, Yamazaki Etsuko, Shirasugi Yukari, Inoue Yasuyuki, Watanabe Shigeki, Fujisawa Shin
Department of Hematology, Kanagawa Cancer Center.
Rinsho Ketsueki. 2012 Jul;53(7):698-704.
We conducted a retrospective study to evaluate outcomes and prognostic factors of newly diagnosed patients with t(8;21) acute myeloid leukemia (AML). There were 70 patients (43 men and 27 women) with a median age of 48 years old (range, 17∼76 years old). Sixty-five patients achieved complete remission (CR) after induction chemotherapy. Fifty-seven patients received consolidation chemotherapy based on the policy of not performing allogeneic hematopoietic stem cell transplantation (allo-HSCT) at the time of first CR. Twenty-seven of the 57 patients relapsed (relapse rate, 47%). The median time from the achievement of the first CR to relapse was 307 days (96∼1,256 days). A white blood cell count of more than 25,400/μl at diagnosis was associated with a higher relapse rate than a white blood cell count of less than or equal to 25,400/μl (75% vs. 43%, P=0.04). Nineteen of the 25 relapsed patients who received re-induction therapy experienced a second CR (second CR rate, 76%). Twenty-six patients (5 with first CR, 12 with second CR, and 9 without remission) received allo-HSCT. The five-year overall survival and disease-free survival rates were 61% and 45%, respectively. Patients with t(8;21) AML had a high CR rate, but about half of them relapsed. However, this report could not show prognostic factors for the identification of patients who should receive allo-HSCT at the time of their first CR.
我们进行了一项回顾性研究，以评估新诊断的t(8;21)急性髓系白血病（AML）患者的治疗结果和预后因素。共有70例患者（43例男性和27例女性），中位年龄为48岁（范围17至76岁）。65例患者诱导化疗后达到完全缓解（CR）。57例患者根据首次CR时不进行异基因造血干细胞移植（allo-HSCT）的策略接受巩固化疗。57例患者中有27例复发（复发率47%）。从首次CR到复发的中位时间为307天（96至1256天）。诊断时白细胞计数超过25400/μl的患者复发率高于白细胞计数小于或等于25400/μl的患者（75%对43%，P=0.04）。接受再诱导治疗的25例复发患者中有19例获得第二次CR（第二次CR率76%）。26例患者（5例首次CR、12例第二次CR和9例未缓解）接受了allo-HSCT。五年总生存率和无病生存率分别为61%和45%。t(8;21) AML患者CR率较高，但约一半患者复发。然而，本报告未能显示出用于识别首次CR时应接受allo-HSCT患者的预后因素。
