璇峰厛鐧诲綍
AML1/ETO阳性急性髓系白血病分子生物学特性的分析(1)
[摘要] 目的 分析AML1/ETO阳性急性髓系白血病AML患者的分子生物学和临床特性，探讨治疗策略。方法 方便选取该院于2011年12月—2016年12月收治的55例AML1/ETO阳性的AML患者的临床特征、形态学、免疫学、以及治疗、生存情况进行分析总结。结果 55例AML1/ETO阳性的AML患者中，白细胞大于10×109/L的30例(55%)，髓外浸润9例(16%)；14例表达CD19(25%)，31例表达CD56(56%)；46例患者进行了诱导化疗，首次化疗CR率为71.7%，二次化疗CR率94.2%，6例死亡；55例骨髓片均有异常中性中幼粒细胞；骨髓中异常中性中幼粒细胞比例(30.567±17.33)%大于原始粒细胞，而外周血中则原始粒细胞比例(16.10±13.35)%高于异常中性中幼粒细胞比例。结论 AML1/ETO阳性AML患者易并发高危因素，明确影响预后的因素，对指导临床治疗和改善AML1/ETO阳性AML患者的生存有重要的意义。
[关键词] AML1/ETO阳性AML；形态学特征；预后因素
[中图分类号] R73 [文献标识码] A [文章编号] 1674-0742(2017)07(a)-0016-04
Analysis of AML1/ETO Positive Acute Myeloid Leukemia Molecular Biological Characteristics
LIANG Chu-jia， LI Jun-xun
First Affiliated Hospital of Zhongshan University， Guangzhou， Guangdong Province， 510080 China
[Abstract] Objective To analyze the AML1/ETO positive acute myeloid leukemia molecular biological characteristics and study the treatment strategies. Methods Convenient selection 55 cases of AML patients with positive AML1/ETO admitted and treated in our hospital from December 2011 to December 2016 were selected and the clinical features， morphology and immunology， treatment and survival situations were analyzed and summarized. Results Of 55 cases， there were 30 cases whose leukocyte was more than 10×109/L (55%)， 9 cases with extramedullary infiltration (16%)， 14 cases with CD19 expression (25%) and 31 cases with CD56 expression (56%)， and 46 cases underwent the induced chemotherapy， and the first chemotherapy CR rate and second chemotherapy CR rate were respectively 71.7% and 94.2%， and 6 cases died， and there were abnormal neutrophilic granulocytes in 55 cases of bone marrow smears， and the ratio of abnormal neutrophilic granulocytes in bones was (30.567±17.33)%， which was bigger than that of myeloblast， and the ratio of myeloblast ratio in the peripheral blood was (16.10±13.35)%， which was higher than that of abnormal neutrophilic granulocytes. Conclusion The AML patients with positive AML1/ETO are easy to be complicated by high-risk factors， and we should clear the prognosis influence factors， and it is of important significance to guiding the clinical treatment and improving the survival situation of them.
[Key words] AML patients with positive AML1/ETO； Morphological characteristics； Prognosis factors
AML1/ETO陽性是AML常见的融合基因，AML-M2(FAB分型)在临床上最为常见，其发病原因主要是由于t(8；21)(q22；q22)累及8号染色体上的ETO基因和21号染色体上的AML1基因易位导致AML1/ETO病变发生[1]。文献普遍描述伴有AML1/ETO阳性的AML预后良好，但影响AML1/ETO预后的因素较多，除髓外侵犯、附加核型异常等因素影响外，临床通过研究发现，分子生物学异常也是导致该疾病发生的高危因素。该文方便选取中山一院在2011年12月—2016年12月期间收治的55例AML1/ETO阳性的AML患者为研究对象，并通过分析其临床特征，探究AML1/ETO阳性急性髓系白血病疾病的分子生物学和临床特性，并探讨治疗策略，现报道如下。(梁楚嘉 李俊勋)