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目的对急性髓系白血病(AML)患者的WHO分型系统进行评价。方法对按FAB标准确诊并进行了染色体核型分析和/或AML特异相关融合基因检测的259例AML和21例RAEB蛳t患者,重新分类计数其血片和骨髓片,按WHO标准回顾性进行分型诊断,并进行了按WHO标准分型诊断后各亚型之间的诱导化疗疗效比较。结果21例RAEB蛳t患者中2例按WHO标准重新诊断为AML。AML伴(t8;21)/AML1蛳ETO与按国内AML标准确诊的M2b、AML伴t(15;17)/PML蛳RARα与M3/M3v、AML伴inv(16)(p13q22)或t(16;16)(p13;q22)/CBFB蛳MYH11与M4Eo的吻合率为100%。21例(11.2%)的患者重新归入AML伴有多系发育异常。AML伴t(8;21)/AML1蛳ETO和AML伴inv(16)(p13q22)或t(16;16)(p13;q22)/CBFB蛳MYH11患者的诱导化疗CR率显著高于不另做分类的AML患者(P<0.05)。有多系增生异常患者的诱导化疗CR率明显低于无多系增生异常患者(P<0.05)。结论AML的WHO分型各亚型的一致性及与临床疗效相关性较FAB分型更好。
Objective To evaluate the WHO typing system in patients with acute myeloid leukemia (AML). Methods A total of 259 cases of AML and 21 cases of RAEB patients diagnosed according to FAB standard and analyzed by chromosomal karyotyping and / or AML-specific fusion gene were rechecked and classified according to the WHO standard Type diagnosis, and carried out according to WHO standard classification of the diagnosis after the induction of chemotherapy between subtypes comparison. Results Two of the 21 RAEB patients were re-diagnosed as AML according to WHO criteria. AML with (t8; 21) / AML1 蛳 ETO with M2b, AML with t (15; 17) / PML 蛳 RARα and M3 / M3v, AML with inv (16) (p13q22) or t ; 16) (p13; q22) / CBFB 蛳 The coincidence rate between MYH11 and M4Eo was 100%. Twenty-one patients (11.2%) were reintroduced into AML with multiple lineage dysplasia. The CR rate of induction chemotherapy in patients with MYH11 with AML with t (8; 21) / AML1 蛳 ETO and AML with inv (16) (p13q22) or t (16; 16) (p13; q22) / CBFB was significantly higher than those without AML patients classified (P <0.05). The CR rate of induced chemotherapy in patients with multiple dysplasia was significantly lower than that in patients without multiple dysplasia (P <0.05). Conclusions The consistency of the WHO subtypes of AML and its correlation with clinical efficacy is better than FAB classification.