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目的 对急性髓细胞性白血病 1(AML1) /ETO(eighttwentyone)融合基因阳性及阴性的两组病例的主要临床指标进行比较分析 ,并探讨AML1/ETO融合基因检测在儿童急性非淋巴细胞白血病 (ANLL)的临床诊断及预后判断中的意义。方法 采用巢式逆转录聚合酶链反应 (RT PCR) )检测白血病患儿AML1/ETO融合基因 ,并进行法 美 英 (FAB)及形态学 免疫学 细胞遗传学 (MIC)分型。诱导治疗主要采用柔红霉素、阿糖胞苷 (DA)、DA +依托泊甙 (足叶乙甙 ,DAE)、柏林 法兰克福 慕尼黑(BFM)方案。结果 在 2 1例AML1/ETO融合基因表达的ANLL中 ,经FAB及MIC分型 ,17例为急性粒细胞白血病部分分化型 (M2 ) ,占 81% ,另外 4例分别是骨髓异常增生综合征 转化中的原始细胞增多的难治性贫血 (MDS RAEB T)后转为M2 型 1例 ,急性粒单细胞白血病伴嗜酸细胞增多 (M4EO) 1例 ,急性单核白血病 (M5) 1例和嗜酸性粒细胞白血病 1例。可评定疗效的 2 0例中 ,18例达到完全缓解(CR) ,CR率达 90 %。 8例同期收治的ANLL无融合基因和基因异常的病例 ,CR率达 87 5 %。结论 AML1/ETO融合基因阳性及阴性的两组病例 ,在各主要临床指标方面差异没有显著性。采用RT PCR检测白血病患儿AML1/ETO融合基因是一种快速、简便、灵敏的辅助诊断方法 ,对ANLL的诊断
Objective To compare and analyze the main clinical data of two groups of AML1 / ETO fusion gene positive and negative cases and to explore the clinical significance of AML1 / ETO fusion gene detection in children with acute non-lymphocytic leukemia (ANLL ) Clinical diagnosis and prognostic significance. Methods AML1 / ETO fusion gene was detected by nested reverse transcriptase polymerase chain reaction (RT PCR) in children with leukemia. FAB and morphological immunocytochemistry (MIC) typing were performed. Induction therapy mainly used daunorubicin, cytarabine (DA), DA + etoposide (etoposide, DAE), Berlin, Frankfurt, Munich (BFM) program. Results In 21 ANLL cases with AML1 / ETO fusion gene expression, 17 cases were partially differentiated (81%) of acute myeloid leukemia by FAB and MIC, and 81% were acute myeloid leukemia. The other 4 cases were myelodysplastic syndrome One case of type M2, one case of acute myelomonocytic leukemia with eosinophilia (M4EO), one case of acute monocytic leukemia (M5), and one case of acute monocytic leukemia (M5) were transformed into refractory anemia (MDS RAEB T) One case of eosinophilic leukemia. Among the 20 evaluable curatives, 18 achieved complete remission (CR) and the CR rate reached 90%. In 8 cases of ANLL with no fusion gene and gene abnormalities, the CR rate reached 87.5%. Conclusion There is no significant difference in the major clinical indexes between the two groups of positive and negative AML1 / ETO fusion genes. The detection of AML1 / ETO fusion gene in children with leukemia by RT-PCR is a rapid, simple and sensitive method for the diagnosis of ANLL