AML1-ETO融合基因转阴对急性髓细胞白血病预后的影响

目的:探讨AML1-ETO融合基因阳性表达的急性髓细胞白血病（acute myelocytic leukemia，AML）患者治疗后融合基因转阴及转阴时间长短对AML患者预后的影响。方法:对2012年1月1日至2016年12月31日在中国医科大学附属盛京医院住院治疗的35例初诊AML1-ETO融合基因阳性AML患者的临床资料进行回顾性分析，总结其形态学、免疫学和分子生物学特征，用 Kaplan-Meier 曲线评估患者生存情况。结果:35例患者男女比例 1.33∶1，中位年龄为34岁(15~71岁)。中位随访时间为16(4~61)个月，诱导缓解率为82.9%，3个疗程或以上缓解占14.3%(n=5)，始终未缓解占2.9%(n=1)，复发率35.3％(n=12)，复发中位时间 12（6~20）个月。其中11例治疗后融合基因转阴，包括3个月内转阴占63.6%（n=7），大于3个月转阴占36.4%（n=4）。单因素分析表明AML1-ETO融合基因转阴患者OS和PFS高，预后较好，AML1-ETO融合基因转阴时间长短对患者长期生存的影响无统计学意义（P=0.707）。结论:AML1-ETO融合基因转阴的AML患者预后较好，AML1-ETO融合基因转阴时间长短对患者的长期生存无明显影响。

The effect of AML1-ETO fusion gene switched on the prognosis of patients in acute myeloid leukemia

Objective:To investigate the effect of AML1-ETO fusion gene switched time on the prognosis of post-treatment patients in acute myeloid leukemia (AML).Methods:The clinical data of 35 newly diagnosed AML patients with AML1-ETO fusion gene，treated in Shengjing Hospital Affiliated to China Medical University from 2012-01-1 to 2016-12-31，were retrospectively analyzed.Their characteristics of morphology，immunology and molecular biology were summarized and their survival were evaluated by Kaplan-Meier curve.Results:The male to female ratio of 35 patients with AML1-ETO gene was 1.33∶1，and the median age was 34 years (15~71 years).The median follow-up was 16 months (4~61).The remission rate was 82.9%.3 cycles or more remission accounted for 14.3%(n=5) and never remission accounted for 2.9%(n=1).Recurrence rate was 35.3%(n=12).The median time of recurrence was 12 months (6~20).There were 11 patients with AML1-ETO fusion gene switched after treatment，within 3 months accounting for 63.6%(n=7) and more than 3 months accounting for 36.4%(n=4).One-way analysis showed that in patients with AML1-ETO fusion gene switched，the OS and PFS were longer and their prognosis were better than still positive ones.The length of AML1-ETO fusion gene switched time had no statistical significance to the long term survival of patients(P=0.707).Conclusion:The prognosis of AML patients with AML1-ETO fusion gene switched were better than still positive one.The long-term survival has no significant effect on the patients by the length of AML1-ETO fusion gene switched duration.