103例急性红白血病患者生物学特征与疗效观察

发布时间：2018-03-03 21:31

本文选题：急性红白血病　切入点：免疫分型　出处：《中国实验血液学杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的:本研究总结分析急性红白血病(AEL)的生物学特征与疗效。方法:回顾性分析2009年6月至2016年5月收治的103例急性红白血病患者肝功能、乳酸脱氢酶、凝血、形态学、免疫学、细胞遗传学及分子生物学特征,通过缓解率、复发率、无复发生存及总生存等指标观察疗效。结果:白细胞、粒细胞、血红蛋白及血小板中位数分别为3.04×10~9/L、0.67×10~9/L、66 g/L及45.0×10~9/L,71.1%的患者外周血涂片可以发现有核红细胞,无1例患者出现凝血功能异常,患者主要表达:CD13(93.5%)、CD117(89.1%)、HLA-DR(87.0%)、CD34(80.0%),部分患者表达淋系抗原CD4(42.9%)及CD7(28.9%)。82例患者核型分析显示,正常核型52.4%(43/82),异常核型41.5%(34/82),检查失败6.1%(5/82)。34例异常核型中,简单异常41.2%(14/34),复杂核型58.8%(20/34)。对60例患者检测融合基因显示,阳性率为16.7%(10/60)。27例患者检测预后基因突变显示,阳性率为77.8%(21/27)。初诊急性红白血病103例中接受化疗81例,可进行疗效分析66例。2个疗程累积缓解率45.5%(30/66),复发率36.7%(11/30),中位复发时间15.5(6.2-50)个月。可进行疗效分析66例患者中位生存时间为29个月。CR(30例)患者截至随访结束未达中位生存时间,明显优于未获CR(36例)患者12个月(P=0.001)。CR患者5年生存率65%,无复发生存(RFS)中位时间46.2个月,3年RFS为58%。结论:AEL患者具有高表达CD34抗原、多为复杂核型等生物学特点。虽然AEL患者缓解率低,生存期短,但缓解患者人群具有较好的长生存及良好的生存质量。
[Abstract]:Objective: to summarize and analyze the biological characteristics and efficacy of acute erythroleukemia (AELL). Methods: the liver function, lactate dehydrogenase, coagulation and morphology of 103 patients with acute erythroleukemia from June 2009 to May 2016 were retrospectively analyzed. Immunological, cytogenetic and molecular biological characteristics were observed through the indicators of remission rate, recurrence rate, relapse free survival and total survival. Results: leukocytes, granulocytes, leukocytes, granulocytes, leukocytes, granulocytes, etc. The median of hemoglobin and platelets were 3.04 脳 10 ~ (9) / L 0.67 脳 10 ~ (-9) / L ~ (66) g / L and 45.0 脳 10 ~ (9) / L ~ (-1) L ~ (-1)% of the patients' peripheral blood respectively. The karyotype analysis of patients with CD7(28.9%).82 showed that normal karyotype was 52.4% / 82.82%, abnormal karyotype was 41.5% / 3482%, and the failure of the examination was 6.11% / 822%. 34 cases of abnormal karyotypes were simple abnormal 41.22% 14 / 34%, complex karyotypes 58.88% / 203434%. 60 patients were examined with fusion gene display, and 60 patients were examined by the fusion gene display of the normal karyotype of 52.44%, abnormal karyotype of 41.5% -822%, and simple abnormal karyotype of 41.21% / 84%, and complex karyotype of 58.88% / 203434%, respectively. In 60 patients, the fusion gene was detected. The positive rate was 16. 7 / 10 / 60. 27 patients with prognostic gene mutation. The positive rate was 77. 8% 21 / 27. Among 103 patients with newly diagnosed acute erythroleukemia, 81 received chemotherapy. The cumulative remission rate of 45.5 / 66 / 66, the recurrence rate of 36.7 / 30 / 30, the median recurrence time of 15.56.2-50 months, the median survival time of 66 patients (29 months 路CR-0.30) were analyzed.) the median survival time was not reached at the end of follow-up. The 5-year survival rate was 65.The median survival time was 46.2 months and the 3-year RFS was 58.Conclusion the patients with CR(36 have high expression of CD34 antigen. Although the remission rate of AEL patients is low and the survival time is short, the remission patients have good long-term survival and good quality of life.
【作者单位】：福建医科大学附属协和医院福建省血液病研究所福建省血液病重点实验室;
【基金】：福建省自然科学基金(2014J01328) 国家及省临床重点专科建设项目(201130301)
【分类号】：R733.71

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