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急性白血病中DNA非整倍体的频率及临床意义

Frequency and clinical significance of DNA aneuploidy in acute leukemia.

作者信息

Hiddemann W, Wörmann B, Ritter J, Thiel E, Göhde W, Lahme B, Henze G, Schellong G, Riehm H, Büchner T

出版信息

Ann N Y Acad Sci. 1986;468:227-40. doi: 10.1111/j.1749-6632.1986.tb42042.x.

Abstract

Analyses of the cellular DNA content were carried out in 446 patients with newly diagnosed acute myeloid (AML) and lymphoblastic (ALL) leukemias in order to assess the frequency of DNA aneuploidies and its relation to immunologic and morphologic subtypes as well as its prognostic relevance. Based on high resolution FCM analyses and standardized reference measurements, DNA aneuploidies were identified at a similar frequency in children and adults with AML (38.0% and 40.0%) and ALL (40.0% and 37.4%). In AML aneuploid DNA stemlines were significantly less frequent in FAB-M 1 cases as compared to the other morphologic subtypes (p less than 0.05), whereas the degree of DNA aneuploidy was significantly lower in M 1 and M 2 leukemias as compared to the M 4 and M 5 subgroups (p less than 0.05). In ALL non-T/non-B and C-ALL revealed a higher frequency of DNA aneuploidies than T- and Null-ALL cases (p less than 0.05). No differences in the response to induction therapy were found between patients with and without DNA aneuploidy in children or adults with AML or ALL. In the childhood ALL trial BFM 79/81, however, a significantly higher frequency of long term remissions was observed in children with DNA aneuploidy (0.91 versus 0.66 at five years, p = 0.053). A similar though not significant tendency was also revealed from the AML studies BFM 78 in children and 78/81 in adults. In the subsequent studies these differences could not be confirmed at present, possibly because of the considerably shorter observation time.

摘要

对446例新诊断的急性髓细胞白血病(AML)和淋巴细胞白血病(ALL)患者的细胞DNA含量进行了分析,以评估DNA非整倍体的频率及其与免疫和形态学亚型的关系以及其预后相关性。基于高分辨率流式细胞术(FCM)分析和标准化参考测量,在儿童和成人AML(分别为38.0%和40.0%)及ALL(分别为40.0%和37.4%)中,DNA非整倍体的识别频率相似。在AML中,与其他形态学亚型相比,FAB-M1病例中的非整倍体DNA干系频率显著较低(p<0.05),而与M4和M5亚组相比,M1和M2白血病中的DNA非整倍体程度显著较低(p<0.05)。在ALL中,非T/非B和C-ALL显示的DNA非整倍体频率高于T-ALL和Null-ALL病例(p<0.05)。在儿童或成人AML或ALL中,有或无DNA非整倍体的患者在诱导治疗反应方面未发现差异。然而,在儿童ALL试验BFM 79/81中,DNA非整倍体儿童的长期缓解频率显著更高(5年时为0.91对0.66,p = 0.053)。儿童AML研究BFM 78和成人研究BFM 78/81也显示出类似但不显著的趋势。在随后的研究中,目前无法证实这些差异,可能是因为观察时间明显较短。

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