Ma R J, Zhu Z M, Yuan X L, Jiang L, Yang S W, Yang J, Guo J M, Shi J, Lei P C, Zhang L, Shang B J, Sun K, Zhai Y P, Li W, Zhang Y
Department of Hematology, Henan Provincial People's Hospital, Henan University, Zhengzhou 450003, China.
Zhonghua Xue Ye Xue Za Zhi. 2017 Jul 14;38(7):592-596. doi: 10.3760/cma.j.issn.0253-2727.2017.07.007.
To explore the prognostic value of CD34, CD2, CD56 expressions and FLT3-ITD mutation in adults with acute promyelocytic leukemia (APL) . The immuno-phenotypic and molecular characteristics of 137 adult patients with APL (from January 2010 to March 2016, in Henan Provincial People's Hospital) were investigated. And the relationships between CD34, CD2, CD56 expressions, FLT3-ITD mutation and the outcomes of high WBC counts at onset, complete remission (CR) rate, early mortality, relapse rate (RR) , overall survival (OS) , disease free survival (DFS) were explored. ①Among the 137 patients, the positive ratios of CD34, CD2, CD56 expressions and mutation rate of FLT3-ITD were 26.3%, 25.5%, 10.2% and 17.5%, respectively. The morbidities of positive CD34, CD2, CD56 expressions and FLT3-ITD mutation in the high-risk group were 43.2%, 47.7%, 18.2% and 27.3% respectively, while those in the low-/intermediate-risk groups were 18.3%, 15.1%, 6.5% and 12.9%, respectively (<0.05) . ②At a median follow-up of 41 months, the total CR rate of the 137 adults APL patients was 96.9%, early mortality 6.6% and relapse rate 7.3% respectively. And RR of positive CD34 or CD2 expression patients was higher than negative CD34/CD2 expression ones (18.8% 3.3%, (2)=8.462, =0.004; 16.1% 4.3%, (2)=4.382, =0.028, respectively) . In addition, the early mortality of patients with positive CD56 expression or FLT3-ITD mutation was extremely higher than in negative ones (21.4% 4.9%, (2)=5.610, =0.018; 16.7% 4.4%, (2)=4.833, =0.028, respectively) . ③The whole OS and DFS were 88.3% and 84.7%, respectively. Wherein, OS and DFS in patients with CD34(+), CD56(+) or FLT3-ITD mutation were worse (<0.05) . Positive CD34, CD2, CD56 expression and FLT3-ITD mutation were latent poor prognostic factors in adults with APL.
探讨CD34、CD2、CD56表达及FLT3-ITD突变在成人急性早幼粒细胞白血病（APL）中的预后价值。对137例成人APL患者（2010年1月至2016年3月，河南省人民医院）的免疫表型和分子特征进行研究。并探讨CD34、CD2、CD56表达、FLT3-ITD突变与发病时高白细胞计数、完全缓解（CR）率、早期死亡率、复发率（RR）、总生存期（OS）、无病生存期（DFS）等预后指标之间的关系。①137例患者中，CD34、CD2、CD56表达阳性率及FLT3-ITD突变率分别为26.3%、25.5%、10.2%和17.5%。高危组CD34、CD2、CD56表达阳性及FLT3-ITD突变的发生率分别为43.2%、47.7%、18.2%和27.3%，而低/中危组分别为18.3%、15.1%、6.5%和12.9%（P<0.05）。②中位随访41个月，137例成人APL患者的总CR率为96.9%，早期死亡率为6.6%，复发率为7.3%。CD34或CD2表达阳性患者的RR高于CD34/CD2表达阴性者（分别为18.8%对3.3%，χ2=8.462，P=0.004；16.1%对4.3%，χ2=4.382，P=0.028）。此外，CD56表达阳性或FLT3-ITD突变患者的早期死亡率极显著高于阴性者（分别为21.4%对4.9%，χ2=5.610，P=0.018；16.7%对4.4%，χ2=4.833，P=0.028）。③总体OS和DFS分别为88.3%和84.7%。其中，CD34(+)、CD56(+)或FLT3-ITD突变患者的OS和DFS较差（P<0.05）。CD34、CD2、CD56表达阳性及FLT3-ITD突变是成人APL潜在的不良预后因素。
