AML1-ETO融合基因在儿童急性髓系白血病中的预后评估价值

目的 评估AML1 ETO融合基因对儿童急性髓系白血病的预后作用.方法 对AML1 ETO阳性或阴性的103例急性粒细胞白血病（AML）患儿的临床资料进行回顾性分析,采用Kaplan-Meier曲线评估患儿无病生存（DFS）率和总生存（OS）率,COX回归模型评估儿童急性髓系白血病中的预后因素.结果 ①103例AML患儿均进行了双诱导方案化疗.53例AML1 ETO阳性患儿第1疗程和第2疗程的完全缓解率分别为70％和92％,远期复发9例（17％）,53例患儿的5年DFS率和OS率分别为（63.6±7.3）％和（74.5±8.9）％.50例AML1 ETO阴性患儿第1疗程和第2疗程的完全缓解率分别为72％和94％,远期复发17例（34％）,患儿的5年DFS率和OS率分别为（52.2±6.1）％和（60.7±7.3）％.AML1 ETO阳性患儿远期复发率显著低于AML1 ETO阴性患儿（P＜0.05）,5年DFS率和OS率均显著高于AML1ETO阴性患儿（P＜0.05）;②单因素分析显示AML1 ETO阳性患儿中,年龄是影响预后的独立危险因素,年龄越大出现事故或死亡的风险性越大（P＜0.05）.结论 相比较于AML1 ETO阴性的AML患儿,AML1 ETO阳性的AML患儿经治疗后,其疾病的远期复发率低,长期疗效好,并且年龄是影响其远期治疗效果的重要因素.

Prognosis of AML1-ETO Fusion Gene in Childhood Acute Myeloid Leukemia

Objective To evaluate the prognosis of AML1 ETO fusion gene in childhood acute myeloid leukemia.Methods The clinical data of 103 children who were diagnosed as AML were retrospectively studied.Disease free survival （DFS） and overall survival （OS） rates were estimated by the Kaplan-Meier method.Prognostic factors were evaluated by COX regres sion analysis software.Results ① 103 AML patients received the double induction therapy.For AML1 ETO positive pa tients,the total complete remission （CR） rates were 70％ and 92％ respectively after the first and second chemotherapy course.9 of 53 AML1 ETO positive patients （17％） were relapsed.The 5 year DFS and OS rates were （63.6 ± 7.3） ％ and （74.5 ± 8.9）％ respectively.For AML1 ETO negative patients,the total complete remission （CR） rates were 72％ and 94％ respectively after the first and second chemotherapy course.17 of 50 AML1 ETO negative patients （34％） were re lapsed.The 5 year DFS and OS rates were （52.2±6.1）％ and （60.7±7.3）％ respectively.Compared to AML1 ETO nega tive patients,the relapse rate of AML1 ETO positive patients was significantly lower （P＜0.05）.In consistence with this re sult,the 5 year DFS and OS rates of AML1 ETO positive patients was significantly higher （P＜0.05） than that of AML1 ETO negative patients ; ②Single-variate analysis showed that the age was an independent risk factor for the long term prog nosis for both AML1 ETO positive and negative patients.The older children had a greater risk of experiencing an accident or death （P＜0.05）.Conclusion Compared with AML1 ETO negative AML patients,AML1 ETO positive AML patients had a lower rate of relapse and have a good long term prognosis.Besides,the age would be an important factor that affects the long term therapeutic effect.