Fan Guang-Lai, Jiang Peng-Jun, Yuan Min
Department of Blood Transfusion, Huaian Maternal and Child Health Hospital, Huaian 223002, Jiangsu Province, China,E-mail:
Department of Hematology, Jiangsu Hospital of Traditional Chinese Medicine, Nanjing 210029, Jiangsu Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2020 Oct;28(5):1510-1515. doi: 10.19746/j.cnki.issn.1009-2137.2020.05.014.
To investigate the clinical prognostic factors of initially-treated AML children with t(8;21)/RUNX1-RUNX1T1.
Clinical data of 41 initially-treated AML children with t(8;21)/RUNX1-RUNX1T1 in our hospital in period from January 2009 to January 2017 were retrospectively analyzed. The baseline clinical characteristics, cumulative recurrence, event-free survival (EFS) and overall survival (OS) were recorded, and the influencing factors of prognosis were evaluated by χ2 test and Cox regression model.
The complete remission (CR) rates in the first course and the second course of induction chemotherapy were respectively 82.93% (34/41) and 97.56% (40/41). The median EFS time and OS time were 30 months and 31 months respectively. The EFS rate and OS rate of children with CR after the first treatment course were significantly higher than those of children without CR (P＜0.05). The EFS rate of male children was significantly higher than that of female children (P＜0.05). The OS rate of children < 10 years old was significantly higher than that of children≥10 years old (P＜0.05). The expression level of RUNX1-RUNX1T1 gene after the second induction remission was the influencing factor of cumulative recurrence rate, EFS rate and OS rate in children (P＜0.05). Multivariate analysis by Cox regression model showed that the decreased levels of RUNX1-RUNX1T1 gene expression < 3 log after the second induction remission was the independent risk factor for EFS rate and OS rate in children (P＜0.05). The cumulative recurrence rate of children with RUNX1-RUNX1T1 gene expression increase for＞1 log after decreased 3 log was significantly higher than that of children with≤1 log (P＜0.05).
Iuithally-treated AML children with t(8;21)/RUNX1-RUNX1T1 show the fine clinical prognosis after standard chemotherapy. The expression level of RUNX1-RUNX1T1 gene should be closely relates with the recurrence and long-term survival of AML children.
探讨初治t(8;21)/RUNX1-RUNX1T1急性髓系白血病（AML）患儿的临床预后因素。
回顾性分析2009年1月至2017年1月我院收治的41例初治t(8;21)/RUNX1-RUNX1T1 AML患儿的临床资料。记录其基线临床特征、累积复发情况、无事件生存期（EFS）和总生存期（OS），采用χ2检验和Cox回归模型评估预后的影响因素。
首次诱导化疗和第二次诱导化疗的完全缓解（CR）率分别为82.93%（34/41）和97.56%（40/41）。中位EFS时间和OS时间分别为30个月和31个月。首次治疗疗程后达到CR的患儿的EFS率和OS率显著高于未达到CR的患儿（P＜0.05）。男性患儿的EFS率显著高于女性患儿（P＜0.05）。＜10岁患儿的OS率显著高于≥10岁患儿（P＜0.05）。第二次诱导缓解后RUNX1-RUNX1T1基因的表达水平是患儿累积复发率、EFS率和OS率的影响因素（P＜0.05）。Cox回归模型多因素分析显示，第二次诱导缓解后RUNX1-RUNX1T1基因表达水平下降＜3 log是患儿EFS率和OS率的独立危险因素（P＜0.05）。RUNX1-RUNX1T1基因表达下降3 log后升高＞1 log的患儿的累积复发率显著高于升高≤1 log的患儿（P＜0.05）。
初治t(8;21)/RUNX1-RUNX1T1 AML患儿经标准化疗后临床预后良好。RUNX1-RUNX1T1基因表达水平与AML患儿的复发及长期生存密切相关。
