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頁籤選單縮合
| 題 名 | 探討t(8;21)(q22;q22)-AML M2 (FAB)病人之細胞遺傳學變異與免疫分型的差異對治療及預後影響=Exploring the Impact of Cytogenetic Abnormality and Aberrant Immunophenotyping on the Treatment and Prognosis of AML Patients with t(8;21)(q22;q22) |
|---|---|
| 作 者 | 王一華; 許呈安; 劉又榕; 施佩君; | 書刊名 | Journal of Biomedical & Laboratory Sciences |
| 卷 期 | 36:1 2024.05[民113.05] |
| 頁 次 | 頁8-22 |
| 分類號 | 363.61 |
| 關鍵詞 | RUNX1-RUNX1T1融合基因; 急性骨髓性白血病; 免疫分型; c-KIT基因突變; t(8;21)(q22;q22); RUNX1-RUNX1T1 fusion gene; Acute myeloid leukemia; Immunophenotype; c-KIT mutation; CD56; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | t(8;21)(q22;q22) 染色體突變常出現於急性骨髓性白血病 French-American-British (FAB) 分類中的 M2 型,屬於預後較好的突變型,然而,仍有約三到四成患者會復發。為了探討其他染色體或基因突變、及骨 髓細胞免疫分型特徵對其預後影響,我們整理 35 位 t(8;21)(q22;q22)-AML M2 案例資料,發現帶有至少 三種不同染色體突變的複雜染色體病人,其總體死亡率有較高的趨勢 (33% v.s. 17%, HR=2.96, p=0.1652); 合併有 c-KIT 基因突變的案例整體存活率明顯較低 (c-KITmut: 58%, v.s. c-KITwt: 91%, p=0.0358),若合 併 c-KIT 突變且骨髓細胞表現 CD56 者,移植後 RUNX1-RUNX1T1 融合基因表現量維持較高 (與初診斷 時相比的下降比率平均值分別為 c-KITmut/CD56+: -3.77; 非 c-KITmut/CD56- : -4.50)。因此,在診斷初期, 建議針對染色體核型、c-KIT 基因、CD56 抗原表現特別評估,辨別其預後風險,以考慮更積極的治療方 式,以降低病人復發率、提高存活率。 |
| 英文摘要 | Acute myeloid leukemia (AML) with t(8;21)(q22;q22); RUNX1-RUNX1T1 is generally associated with favorable prognosis. However, the outcome is heterogeneous, and approximately 30%–40% of patients with t(8;21)(q22;q22)-positive AML relapse after standard treatment. In the present study, we analyzed 35 patients with newly diagnosed t(8;21)(q22;q22)-AML-M2 (French-American-British [FAB] classification) to explore the prognostic effects of the cytogenetic abnormality and aberrant immunophenotype. In our cohort, patients with a complex karyotype (CK) had a higher mortality rate (33%) than did those without CK (17%; hazard ratio: 2.96, p = 0.1652). In addition, overall survival (OS) was considerably lower in the patients with additional c-KIT mutation (c-KITmut: 58%) than in those without (c-KITwt: 91%, p = 0.0358). The RUNX1-RUNX1T1 log reduction ratio might be associated with poor outcomes after allogeneic hematopoietic stem cell transplantation in patients with c-KIT mutation combined with aberrant CD56 expression (mean of the RUNX1-RUNX1T1 log reduction ratio: c-KITmut/CD56+: -3.77; non-c-KITmut/CD56- : -4.50). Karyotypes, the c-KIT mutant, and CD56 expression levels in the bone marrow of patients with t(8;21)(q22;q22)-AML-M2 should be investigated because of their potential prognostic significance. |
本系統中英文摘要資訊取自各篇刊載內容。