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目的分析四川地区AML1-ETO融合基因与急性髓系白血病(acute myeloid leukemia,AML)临床特征的相关性,探讨AML-M2型患者预后影响因素。方法选取AML1-ETO融合基因阳性AML-M2患者94例与AML1-ETO融合基因阴性AML-M2患者51例,回顾性比较分析其临床特征、治疗反应,并随访观察两组患者的预后情况。结果与AML1-ETO融合基因阴性AML-M2患者相比,AML1-ETO融合基因阳性AML-M2患者的临床症状差异无统计学意义(P>0.05),主要以贫血、发热、出血为主;两组患者的红细胞(RBC)、血小板(PLT)、粒红比、粒系(NC)%、CD34、人类白细胞DR抗原(HLA-DR)、CD56、CD19差异有统计学意义(P<0.05),数据的中位数值除RBC、PLT偏低外,其余均偏高;两组患者疗效与生存曲线分布差异无统计学意义(P>0.05);在AML-M2患者的长期生存影响因素分析中,CD56、骨髓原粒细胞百分比是长期生存的不利因素,完全缓解因素对长期生存有利。结论四川地区AML1-ETO融合基因阳性AML-M2人群与阴性人群相比,临床症状无特异,除部分血液、骨髓、流式实验数据有差异外,其他临床特征相似。两组患者的生存分析和预后也无明显差异,AMLM2疗效和预后影响因素多,准确评价AML1-ETO的预后诊断作用,应采用分层分析。
Objective To analyze the correlation between the AML1-ETO fusion gene and the clinical features of acute myeloid leukemia (AML) in Sichuan and to explore the influencing factors of prognosis in AML-M2 patients. Methods Totally 94 patients with AML1-ETO fusion gene positive AML-M2 and 51 AML1-ETO fusion negative AML-M2 patients were retrospectively analyzed. The clinical features and response were analyzed retrospectively. The prognosis of the two groups was followed up. Results Compared with AML1-ETO fusion gene negative AML-M2 patients, AML1-ETO fusion gene positive AML-M2 patients showed no significant difference in clinical symptoms (P> 0.05), mainly anemia, fever and bleeding; There were significant differences in RBC, PLT, NC, CD34, HLA-DR, CD56 and CD19 between the two groups (P <0.05) In addition to the median RBC, PLT low, the rest of the data were high; the two groups of patients with no significant difference in the distribution of efficacy and survival curve (P> 0.05); AML-M2 patients with long-term survival factors, CD56, the percentage of myeloblast of bone marrow is the unfavorable factor of long-term survival, and the complete remission factor is beneficial to long-term survival. Conclusions The clinical features of AML1-ETO fusion positive AML-M2 population in Sichuan are similar to those in negative population, except for some blood, bone marrow and flow cytometry data. There was no significant difference in survival analysis and prognosis between the two groups. AMLM2 has many curative effects and prognostic factors. Accurate evaluation of the prognostic value of AML1-ETO should be performed by stratified analysis.