摘要
目的探讨EVI1基因表达与儿童急性髓细胞白血病(AML)临床表现及预后的关系。方法检测AML患儿EVI1基因表达,分析EVI1阳性AML患儿临床和实验室检查特点以及预后。结果 145例AML患儿中EVI1阳性38例,占26.21%。与阴性组相比,阳性组患儿的年龄、性别、血红蛋白量、白细胞及血小板计数、细胞形态学FAB分型、异常核型检出率差异均无统计学意义(P>0.05);阴性组复杂核型检出率高于阳性组,差异有统计学意义(χ2=5.50,P=0.019)。38例阳性患儿中,14例化疗与7例异基因造血干细胞移植(allo-HSCT)患儿的无事件生存(EFS)率差异有统计学意义(χ2=4.00,P=0.045)。阳性组与阴性组患儿化疗完全缓解率差异无统计学意义(91.67%对91.18%,P>0.05),阳性组患儿复发率高于阴性组,差异有统计学意义(64.29%对22.22%,P=0.009);两组EFS率差异也有统计学意义(χ2=5.76,P=0.015)。2例阳性组患儿骨髓复发时EVI1基因仍阴性。结论 EVI1基因是儿童AML的不良预后因素,allo-HSCT可改善EVI1阳性AML患儿预后。定量检测EVI1基因表达可能不适用于微小残留病监测。
Objective To investigate the relationship between EVI1gene expression and clinical features and prognosisof children with acute myeloid leukemia(AML).Methods EVI1gene was detected in AML children,correlation of clinicaland lab features,prognosis of AML children with EVI1gene were analyzed.Results EVI1expression is positive in38of145children with AML.There were no significant differences in age,gender,hemoglobin concentration,leukocytes and plateletcount,subtype of morphology,ratio of chromosomal anomaly and complex karyotypes between EVI1positive and EVI1negativegroup(P>0.05);coexist genes were detected in9cases(23.68%)of EVI1positive group.Rate of complete remission(CR)was91.67%in24cases of EVI1positive patients received chemotherapy.Relapse rate was64.29%and14.29%in EVI1positivepatients who received chemotherapy and allo-hematopoietic stem cell transplantation(allo-HSCT),retrospectively and significantdifferences were found(P<0.05).There was no significant difference in CR but significant difference was found in event freesurvival(P<0.05)for EVI1positive and EVI1negative patients who received chemotherapy.EVI1gene kept negative whenbone marrow relapse occurred in two patients with EVI1positive at diagnosis.Conclusion EVI1gene may play adverse role inpediatric AML;prognosis of EVI1positive AML patients can be improved by allo-HSCT;follow-up of EVI1transcript levels isinsufficient to monitoring of minimal residual disease.
作者
郑晨钰
温贤浩
郭玉霞
管贤敏
于洁
肖剑文
ZHENG Chenyu;WEN Xianhao;GUO Yuxia;GUAN Xianmin;YU Jie;XIAO Jianwen(Children’s Hospital of Chongqing Medical University, Pediatric Research Institute of Children’s Hospital, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China)
出处
《临床儿科杂志》
CSCD
北大核心
2017年第5期331-335,共5页
Journal of Clinical Pediatrics
基金
重庆市卫生计生委医学科研项目(No.2015msxm042)
