论文部分内容阅读
本研究旨在分析急性红白血病的临床特征及其预后。回顾性分析2007年10月到2012年10月共收治305例急性白血病患者中13例急性红白血病患者的临床特征,及其形态学,免疫学、细胞遗传学和分子生物学检查结果。结果表明,红系及非红系同时表达增高,髓系抗原主要表达CD13、CD33、CD117、CD34,部分有核红系抗原表达Gly、CD71。核型分析显示3例有轻微核型异常,2例有复杂核型,1例为正常核型,在其余患者未检测。分子生物学检测发现,5例存在预后不良基因,其中3例MLL-MLL融合基因阳性,1例MLL突变,1例为NRAS基因突变,在其余8例中未检测出异常基因。经含地西他滨诱导化疗方案治疗,患者CR率为53.8%(7/13),PR率为15.4%(2/13),最终8例患者行异基因造血干细胞移植。3年OS率79%,3年RFS率78%。结论:AML-M6为急性白血病中特殊亚型,由MDS转化,含有不良基因,预后较差,采用异基因造血干细胞移植及DAC相关化疗方案可以提高生存率。
The aim of this study was to analyze the clinical features and prognosis of acute erythroleukemia. The clinical features, morphological, immunological, cytogenetic and molecular biological findings of 13 acute erythroleukemia patients from 305 patients with acute leukemia were retrospectively analyzed from October 2007 to October 2012. The results showed that erythroid and non-erythroid simultaneously expressed increased myeloid antigens mainly expressed CD13, CD33, CD117, CD34, some of the erythroid line antigen expression of Gly, CD71. Karyotype analysis showed mild karyotypic abnormalities in 3 cases, complex karyotypes in 2 cases, normal karyotype in 1 case, and no detection in the remaining cases. Molecular biology tests showed that 5 cases had poor prognosis genes, including 3 cases of MLL-MLL fusion gene positive, 1 case of MLL mutation and 1 case of NRAS gene mutation. In the remaining 8 cases, no abnormal gene was detected. After chemotherapy with gemcitabine, the CR rate was 53.8% (7/13) and the PR rate was 15.4% (2/13). The final 8 patients underwent allogeneic hematopoietic stem cell transplantation. 3-year OS rate of 79%, 3-year RFS rate of 78%. Conclusion: AML-M6 is a special subtype of acute leukemia, which is transformed by MDS and contains bad genes. The prognosis is poor. Allogeneic hematopoietic stem cell transplantation and DAC-related chemotherapy can improve the survival rate.