AML1-ETO阳性的儿童急性髓系白血病疗效分析

目的探讨儿童急性髓系白血病m2型伴AML1-ETO阳性患儿的疗效及预后相关因素。方法2003年1月至2008年12月收住AML1-ETO阳性儿童m233例,并对患儿进行总结分析、随访。了解患儿临床特征,免疫分型,染色体核型治疗及疗效,生存情况及影响治疗的因素。结果33例AML1-ETO阳性儿童第一疗程诱导缓解率为63.5%,中位随访时间32个月,目前仍处于CR状态25例占75.5%,5例患儿骨髓复发,复发率为15.1%,高白细胞数,多脏器受累,免疫表型CD5＋6以及第一疗程诱导治疗未达缓解者预后不良,并伴有较低的生存率。结论儿童急性髓系白血病M2伴有AML1-ETO阳性患儿预后是好的。强烈化疗高剂量阿糖胞苷能帮助提高疗效。提高生存率。高白细胞计数,累及多脏器以及CD56标记阳性和初次诱导治疗的缓解不佳,影响总的生存率。

Analysis of clinical outcome of childhood acute myeloid leukemia with AML1-ETO Xue

Objective To analyze the clinical and prognostic factors of childhood acute myeloid leukemia with AML1-ETO. Methods Thirty-three children with AML1-ETO were analyzed on clinical features, immunophenotype, chromosome karyotype, treatment outcome and survival rate from 2003 to 2008. Results The complete remission rate of patients was 63.6% after the first course of induction therapy. Twenty-five children maintained complete remission （75.5 % ） and 5 children had bone marrow relapse （15.1% ）. The median follow-up time was 32 months. White blood cells 325 × 10^9/L, multiple ＇organ involved, CD56 positive and non-remission in the first induction therapy indicated poor prognosis. Conclusion Childhood acute myeloid leukemia with AML1-ETO have better prognosis. High whiteblood-cell count, multiple organ involved, CD56 positive and non-remission in the first induction therapy influence overall survival rate. Application of high dose Ara-C in consolidation therapy can improve therapeutic efficacy and prolong survival rate.