Zhang J P, Lin D, Wang S C, Li Y, Chen Y M, Wang Y, Wei H, Mi Y C, Wang J X
Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences, State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Disease, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2020 Dec 14;41(12):1008-1012. doi: 10.3760/cma.j.issn.0253-2727.2020.12.007.
To investigate the clinical characteristics, etiology, and prognosis of familial acute myeloid leukemia (AML) with germline CEBPA mutation and improve the understanding of familial leukemia. The age of onset, clinical characteristics, outcome, and prognosis of a family of patients with AML were investigated, and the family tree of the cases was displayed. Bone marrow and oral mucosal cells were collected from the proband, and peripheral blood was collected from the relatives of the proband. Gene mutation was detected by gene sequencing technology. A total of 10 patients in this family were diagnosed with acute leukemia, including 4 males and 6 females, with a median age of 9 (3-48) years. Of the 10 patients, six died. Among them, 4 patients did not receive treatment, 1 patient survived 3 years after chemotherapy and died of relapse, and one patient died 2 years after receiving traditional Chinese medicine and supportive treatment. Four patients are alive. One patient has survived 15 years through chemotherapy, and three patients have survived with chemotherapy combined with hematopoietic stem cell transplantation, and the survival time was 6, 9, and 28 months at the end of follow-up. Gene sequencing was performed on proband and 8 relatives of the proband, and 5 were found to have the germline CEBPA TAD p.G36Afs*124 mutation. Among the 5 individuals with confirmed CEBPA mutation, 4 were diagnosed with AML, and 1 had not developed disease during follow-up. AML with germline CEBPA gene mutation mostly occurs in children and young adults, with complete or nearly complete penetrance. With active treatment, most of the patients have a favorable prognosis.
探讨伴有胚系CEBPA突变的家族性急性髓系白血病(AML)的临床特征、病因及预后,以提高对家族性白血病的认识。调查了一个AML患者家族的发病年龄、临床特征、转归及预后,并展示了病例家系图。从先证者采集骨髓和口腔黏膜细胞,从先证者亲属采集外周血。采用基因测序技术检测基因突变。该家族共有10例患者被诊断为急性白血病,其中男性4例,女性6例,中位年龄为9(3 - 48)岁。10例患者中,6例死亡。其中,4例未接受治疗,1例化疗后存活3年死于复发,1例接受中药及支持治疗2年后死亡。4例患者存活。1例患者通过化疗存活15年,3例患者化疗联合造血干细胞移植后存活,随访结束时存活时间分别为6、9和28个月。对先证者及其8名亲属进行基因测序,发现5人有胚系CEBPA TAD p.G36Afs*124突变。在5例确诊有CEBPA突变的个体中,4例被诊断为AML,1例在随访期间未发病。伴有胚系CEBPA基因突变的AML多发生于儿童和青年,具有完全或近乎完全的外显率。积极治疗后,大多数患者预后良好。