本文選題：急性紅白血病　切入點(diǎn)：免疫分型　出處：《中國實(shí)驗(yàn)血液學(xué)雜志》2017年03期 　論文類型：期刊論文

【摘要】：目的:本研究總結(jié)分析急性紅白血病(AEL)的生物學(xué)特征與療效。方法:回顧性分析2009年6月至2016年5月收治的103例急性紅白血病患者肝功能、乳酸脫氫酶、凝血、形態(tài)學(xué)、免疫學(xué)、細(xì)胞遺傳學(xué)及分子生物學(xué)特征,通過緩解率、復(fù)發(fā)率、無復(fù)發(fā)生存及總生存等指標(biāo)觀察療效。結(jié)果:白細(xì)胞、粒細(xì)胞、血紅蛋白及血小板中位數(shù)分別為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發(fā)現(xiàn)有核紅細(xì)胞,無1例患者出現(xiàn)凝血功能異常,患者主要表達(dá):CD13(93.5%)、CD117(89.1%)、HLA-DR(87.0%)、CD34(80.0%),部分患者表達(dá)淋系抗原CD4(42.9%)及CD7(28.9%)。82例患者核型分析顯示,正常核型52.4%(43/82),異常核型41.5%(34/82),檢查失敗6.1%(5/82)。34例異常核型中,簡(jiǎn)單異常41.2%(14/34),復(fù)雜核型58.8%(20/34)。對(duì)60例患者檢測(cè)融合基因顯示,陽性率為16.7%(10/60)。27例患者檢測(cè)預(yù)后基因突變顯示,陽性率為77.8%(21/27)。初診急性紅白血病103例中接受化療81例,可進(jìn)行療效分析66例。2個(gè)療程累積緩解率45.5%(30/66),復(fù)發(fā)率36.7%(11/30),中位復(fù)發(fā)時(shí)間15.5(6.2-50)個(gè)月�？蛇M(jìn)行療效分析66例患者中位生存時(shí)間為29個(gè)月。CR(30例)患者截至隨訪結(jié)束未達(dá)中位生存時(shí)間,明顯優(yōu)于未獲CR(36例)患者12個(gè)月(P=0.001)。CR患者5年生存率65%,無復(fù)發(fā)生存(RFS)中位時(shí)間46.2個(gè)月,3年RFS為58%。結(jié)論:AEL患者具有高表達(dá)CD34抗原、多為復(fù)雜核型等生物學(xué)特點(diǎn)。雖然AEL患者緩解率低,生存期短,但緩解患者人群具有較好的長(zhǎng)生存及良好的生存質(zhì)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.
【作者單位】： 福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院福建省血液病研究所福建省血液病重點(diǎn)實(shí)驗(yàn)室;
【基金】：福建省自然科學(xué)基金(2014J01328) 國家及省臨床重點(diǎn)�？平ㄔO(shè)項(xiàng)目(201130301)
【分類號(hào)】：R733.71

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本文編號(hào)：1562771