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伴t(8;21)(q22;q22)及Y染色体缺失的急性髓系白血病临床分析

[Clinical analysis of acute myeloid leukemia with t(8;21) (q22;q22) and loss of Y chromosome].

作者信息

Zhu Cheng-Ying, Yang Hua, Niu Jian-Hua, Zhang Qi, Xie Xu-Lei, Wang Li-Jun, Zhu Hai-Yan, Yao Zi-Long, Yu Li, Jing Yu

机构信息

Department of Hematology, Chinese PLA General Hospital Beijing 1000853.

Department of Hematology, The Forth People's Hospital of Jinan, Jinan 250031, Shandong Province, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2014 Aug;22(4):950-6. doi: 10.7534/j.issn.1009-2137.2014.04.013.

Abstract

This study was aimed to investigate the clinical characteristics of acute myeloid leukemia (AML) with t (8;21) (q22;q22) and loss of Y chromosomes. Clinical data of 267 cases of AML were collected from January 2010 to June 2013. Among 267 AML, there were 13 cases with t (8;21) (q22;q22) and loss of Y chromosomes. The clinical data including clinical indicators, treatment protocols, curative effect and prognosis were analyzed retrospectively. The results showed that after normalized chemotherapy, there were 4 patients with complete remission at the first cycle of treatment, 4 patients with complete remission at the second cycle, 4 patients with complete remission at the third cycle, but one patient without complete remission after 4 cycles. There were 6 patients who did not relapse during consolidation and intensive therapy. Among these 6 patients, 4 cases accepted chemotherapy combined with transplantation, other 2 cases accepted chemotherapy. In the remainder 6 patients, 4 cases relapsed once, one cases relapsed twice, 1 cases relapsed for three times. Moreover, 2 cases who accepted the chemotherapy and auto-hematopoietic stem cell trans-plantation, were diagnosed as relapse, after accepted allo-hematopoietic stem cell transplantation, currently are in disease-free status. In follow-up period, the relapse-free survival (RFS) time was 4.67 ± 3.45 months in chemotherapy group, the RFS time is 34.17 ± 21.37 months in chemotherapy and transplantation group. The chemotherapy combined with transplantation extended the RFS time (P < 0.05). It is concluded that the NCCN guide indicates that AML with t (8;21) ( q22;q22) showed a good prognosis. but the clinical course of treatment confirmed that the prognosis of AML patients with t (8;21) (q22;q22) and loss Y chromosomes is poor, including uneasy remission and easy relapse, for improving the prognosis of these patients, the hematopoietic stem cell transplantation should be recommended.

摘要

本研究旨在探讨伴t(8;21)(q22;q22)及Y染色体缺失的急性髓系白血病(AML)的临床特征。收集2010年1月至2013年6月期间267例AML患者的临床资料。在267例AML患者中,有13例伴t(8;21)(q22;q22)及Y染色体缺失。对临床指标、治疗方案、疗效及预后等临床资料进行回顾性分析。结果显示,规范化化疗后,第1周期治疗有4例完全缓解,第2周期有4例完全缓解,第3周期有4例完全缓解,但1例在4个周期后未完全缓解。有6例患者在巩固强化治疗期间未复发。在这6例患者中,4例接受化疗联合移植,另外2例接受化疗。其余6例患者中,4例复发1次,1例复发2次,1例复发3次。此外,2例接受化疗及自体造血干细胞移植的患者,在复发后接受异基因造血干细胞移植,目前处于无病状态。随访期间,化疗组无复发生存(RFS)时间为4.67±3.45个月,化疗联合移植组RFS时间为34.

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