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新西兰波利尼西亚和欧洲患者之间急性早幼粒细胞白血病的种族差异。

Ethnic differences in acute promyelocytic leukaemia between New Zealand Polynesian and European patients.

机构信息

Blood and Cancer Biology Laboratory, Department of Molecular Medicine & Pathology, School of Medical Sciences, University of Auckland, Auckland, New Zealand.

Department of Medicine, University of Otago, Dunedin, New Zealand.

出版信息

Hematology. 2021 Dec;26(1):215-224. doi: 10.1080/16078454.2021.1882146.

Abstract

Ethnic differences in haematologic malignancies remain poorly elucidated, hence research in this area is important. This was a retrospective study into potential ethnic disparity in the presentation and outcomes of acute promyelocytic leukaemia (APL) between New Zealand (NZ) Polynesian and European patients. Data were analysed for patients treated at Auckland City Hospital (ACH;  = 55) and recorded in the New Zealand Cancer Registry (NZCR;  = 173), both for the period 2000-2017. We found that Polynesian patients treated at ACH presented at a younger age than European (= 0.005), showed higher blast counts (= 0.033), and a marginally higher prothrombin ratio (= 0.02). Treatment with all-trans retinoic acid (ATRA) was started faster in Polynesian patients than European (= 0.021), suggesting Polynesians were sicker at presentation but were managed accordingly. There were no differences in bleeding events, transfusion requirements and early deaths during the first month of treatment. Long-term survival was also similar. Data extracted from the NZCR confirmed NZ Polynesian patients with APL were younger than European (< 0.001), but long-term survival was similar (= 0.920). In summary, this study indicates a discrepancy in the presentation and severity of APL between NZ Polynesian and European patients but treatment initiation was rapid with no difference in outcomes. The distinctive features of APL in NZ Polynesians raise the possibility of a predisposing genetic factor or a different risk factor profile, elucidation of which is important for all patients with APL.

摘要

种族间血液系统恶性肿瘤的差异仍未得到充分阐明,因此该领域的研究非常重要。本研究回顾性分析了新西兰(NZ)波利尼西亚裔和欧洲裔急性早幼粒细胞白血病(APL)患者在临床表现和结局方面的潜在种族差异。对奥克兰市医院(ACH)治疗的患者(n=55)和新西兰癌症登记处(NZCR)记录的患者(n=173)进行数据分析,时间范围为 2000-2017 年。我们发现,ACH 治疗的波利尼西亚裔患者比欧洲裔患者的发病年龄更小(P=0.005),原始细胞计数更高(P=0.033),凝血酶原比值稍高(P=0.02)。与欧洲裔患者相比,波利尼西亚裔患者更早开始使用全反式维甲酸(ATRA)治疗(P=0.021),这表明波利尼西亚裔患者的病情更为严重,但得到了相应的治疗。在治疗的第一个月内,两组患者的出血事件、输血需求和早期死亡率没有差异。长期生存情况也相似。从 NZCR 提取的数据证实,新西兰 APL 波利尼西亚裔患者比欧洲裔患者更年轻(P<0.001),但长期生存情况相似(P=0.920)。综上所述,本研究表明新西兰波利尼西亚裔和欧洲裔 APL 患者在临床表现和严重程度方面存在差异,但治疗开始迅速,结局无差异。新西兰波利尼西亚裔 APL 的这些特征提示可能存在易患遗传因素或不同的危险因素谱,这对于所有 APL 患者都很重要。

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