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目的:探讨伴有t(8; 21)染色体异常的急性髓性白血病(acutemyeloidleukemia,AML)的实验室及临床特性,比较伴有附加染色体异常与单纯t(8; 21)AML的差异。方法:回顾性分析72例t(8; 21)AML患者,包括细胞形态学、血象、细胞遗传学G显带核型、免疫表型、AML1 /ETO融合基因及临床特征,并按染色体核型分为单纯组(A组)及伴有附加异常组(B组)进行比较。结果: 72例t(8; 21)AML按FAB分型M2 占65例(90% ),M4 占5例, 2例为M5。单纯易位27例,伴附加染色体异常45例(62. 5% ),主要的附加异常类型为Y, +4,del(9q)。A,B两组在年龄分布、骨髓幼稚细胞数、骨髓Auer小体检出率、骨髓嗜酸细胞数、免疫表型分布、髓外白血病发生率及化疗诱导缓解率上差异无统计学意义,但B组初诊时外周血白细胞数略低,且男性患者比例明显高于A组。随访1 ~96月,A组3年预期生存率为(63. 9±11. 2)%,中位生存时间为65个月;而B组3年预期生存率为(20. 9±9. 2)%,中位生存时间12个月(P<0. 05),但B组各种主要附加异常之间生存时间差别无统计学意义。结论:附加染色体异常是t(8; 21)AML预后不良的重要因素之一,伴有附加异常的t(8; 21)AML生存时间明显短于单纯t(8; 21)者。
OBJECTIVE: To investigate the laboratory and clinical features of acutemyeloid leukemia (AML) associated with t (8; 21) chromosomal abnormalities and to compare the differences between additional chromosomal abnormalities and simple t (8; 21) AML. Methods: A retrospective analysis of 72 cases of t (8; 21) AML patients, including cell morphology, hemogram, cytogenetics G-banding karyotype, immunophenotype, AML1 / ETO fusion gene and clinical features, and according to the karyotype Divided into simple group (A group) and with additional abnormal group (B group) for comparison. Results: 72 cases of t (8; 21) AML accounted for 65 cases (90%) according to FAB classification, M4 accounted for 5 cases and 2 cases were M5. There were 27 cases with simple translocation, 45 cases with extra chromosomal abnormalities (62.5%), and the main additional abnormalities were Y, +4, del (9q). There was no significant difference in the age distribution, the number of naive cells in bone marrow, the detection rate of Auer body of bone marrow, the number of eosinophils in bone marrow, the distribution of immunophenotype, the incidence of extramedullary leukemia and the rate of response to chemotherapy in groups A and B The number of peripheral blood leukocytes in group B was slightly lower than that in group A, and the proportion of male patients was significantly higher than that of group A. The 3- year expected survival rate in group A was (63.9 ± 11.2)% and the median survival time was 65 months. The expected 3-year survival rate in group B was (20.9 ± 9) 2)%, median survival time was 12 months (P <0.05), but there was no significant difference in survival time between the various major additional abnormalities in group B. Conclusions: An additional chromosomal abnormality is one of the major causes of poor prognosis in t (8; 21) AML. The survival time of t (8; 21) AML with additional abnormalities was significantly shorter than that of t (8; 21) alone.