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目的本研究旨在探讨微小残留病监测在t(8;21)急性髓系白血病(AML)中的预后意义。方法回顾性分析于2013年1月至2016年1月就诊于郑州大学人民医院的42例t(8;21)AML患者,应用实时定量PCR(RQ-PCR)技术,连续监测患者的AML1-ETO融合基因表达水平,以此代表微小残留病(MRD),分析其动态变化与复发和预后的关系。结果患者的年龄、性别、白细胞计数、血红蛋白量、血小板水平等临床特征与初诊时的AML1-ETO融合基因表达水平无关。1个疗程巩固治疗后,AML1-ETO融合基因表达水平比诊断时下降小于3个对数级者,与下降大于3个对数级者相比,3年的无病生存率(DFS)分别为:(46.3±9.2)%和(73.4±8.7)%(P=0.017),3年的总生存率(OS)分别为:(49.2±10.7)%和(75.9±9.8)%(P=0.013)。治疗结束随访期间,AML1-ETO融合基因表达水平持续低于0.001%者均未复发。结论 RQ-PCR技术连续动态监测t(8;21)AML的MRD水平,具有重要的预后价值。
Objective This study aimed to investigate the prognostic significance of monitoring minimal residual disease in t (8; 21) acute myeloid leukemia (AML). Methods A total of 42 t (8; 21) AML patients treated at Zhengzhou University People’s Hospital from January 2013 to January 2016 were retrospectively analyzed. The AML1-ETO patients were continuously monitored by real-time quantitative PCR (RQ- Fusion gene expression level, which represents the minimal residual disease (MRD), analysis of its dynamic changes and recurrence and prognosis. Results The clinical features of patients such as age, sex, white blood cell count, hemoglobin and platelet level had no relation with the expression of AML1-ETO fusion gene at the first visit. After 1 course of consolidation therapy, the AML1-ETO fusion gene expression level was less than 3 log lower than at diagnosis, and 3-year disease-free survival (DFS) was The overall 3-year OS was (49.2 ± 10.7)% and (75.9 ± 9.8)%, respectively (P = 0.013) and (46.3 ± 9.2)% and (73.4 ± 8.7)% . During the follow-up of treatment, the expression level of AML1-ETO fusion gene was less than 0.001%, and no recurrence occurred. Conclusions RQ-PCR technique can monitor the level of MRD in t (8; 21) AML continuously and has important prognostic value.