急性髓系白血病伴t(8;21)的臨床特點及預后_《華西醫學》

作者：

曾帆 ¹ , 劉云 ¹ , 周鵬 ² , 謝雪 ¹ ,  常紅 ¹

四川大學華西醫院(成都, 610041) 1 血液內科, 2 耳鼻喉/頭頸外科;

關鍵詞：

急性髓系白血病染色體畸變預后

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【摘要】　目的　探討t(8；21)急性髓系白血病(acute myeloid leukemia，AML)的臨床特點及預后，提高對t(8；21)AML的認識。　方法　 2010年5月收治1例t(8；21)AML患者，對其臨床資料并復習相關文獻進行分析。患者因乏力、皮下瘀斑入院，查體發現患者有胸骨壓痛，脾肋下3 cm觸及，血常規:白細胞80.37×109/L，異常細胞 23%，取患者骨髓液行形態學、流式細胞術檢測及染色體核型檢測。　結果　患者診斷為急性粒細胞白血病部分分化型(AML-M2b)，AML1/ETO融合基因陽性，染色體核型分析t(8；21)(q22；q22)。　結論　 t(8；21)AML是一類較為特殊的急性髓系白血病，在診斷時需尋找疾病的預后因素并進行分層，實施個體化治療。
【Abstract】　Objective　 To obsrve the clinical features and prognosis of acute myeloid leukemia (AML) with t(8;21).　Methods　 The clinical data of one patient with t (8; 21) AML diagnosed in May 2010 was retrospectively analyzed. The chief complaints of the patient were malaise and ecchymosis. The physical examinations revealed sternum pain and splenomegaly; blood routine examination showed that the peripheral WBC count was 80.37×109/L, and the abnormal cells were 23%. Bone marrow samples were collected to perform the morphologic test, flow cytometry analysis and chromosome analysis.　Results　 The patient was diagnosed as AML with maturation (AML-M2) with positive AML1/ETO fusion gene and translocation (8; 21) (q22; q22).　Conclusion　 AML with t (8; 21) is different with other types of AML; patients with AML with t (8; 21) need individualized treatment.

引用本文： 曾帆,劉云,周鵬,謝雪,常紅. 急性髓系白血病伴t(8;21)的臨床特點及預后. 華西醫學, 2010, 25(11): 2004-2006. doi: 復制

1.	Prebet T, Boissel N, Reutenauer S, et al. Acute myeloid leukemia with translocation (8;21) or inversion (16) in elderly patients treated with conventional chemotherapy: a collaborative study of the French CBF-AML intergroup[J]. J Clin Oncol, 2009, 27(28): 4747-4753.
2.	Groupe Français de Cytogénétique Hématologique. Acute myelogenous leukemia with an 8;21 translocation: a report on 148 cases from the Groupe Francais de Cytogénétique Hématologique[J]. Cancer Genet Cytogenet, 1990, 44(2): 169-179.
3.	Han JS, Kim SH, Kwon HC, et al. A case of pathologic splenic rupture as the initial manifestation of acute myeloid leukemia M2[J]. Yonsei Med J, 2010. 51(1): 138-140.
4.	Ferrara F, Vecchio. Acute myeloid leukemia with t(8;21)/AML1/ETO: a distinct biological and clinical entity[J]. Haematologica, 2002, 87(3): 306-319.
5.	牧啟田, 陳志妹, 樓基余, 等. 154例t(8; 21)急性髓系白血病遺傳學分析[J]. 浙江大學學報(醫學版), 2010, 39(3): 236-240.
6.	Yamasaki H, Era T, Asou N, et al. High degree of myeloid differentiation and granulocytosis is associated with t(8;21) smoldering leukemia[J]. Leukemia, 1995, 9(7): 1147-1153.
7.	Bae SY, Kim JS, Ryeu BJ, et al. Acute myeloid leukemia (AML-M2) associated with variant t(8;21): report of three cases[J]. Cancer Genet Cytogenet, 2010, 199(1): 31-37.
8.	Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting[J]. Clin Oncol, 1999, 17(12): 3835-3849.
9.	Fleishma E, Sokova O, Popa AV, et al. Chromosomal translocation t(8, 21) in acute myeloid leukemia of children: prognostic value of additional karyotype abnormalities[J]. Vestn Ross Akad Med Nauk, 2009, 19(6): 9-16.
10.	張建軍, 杜欣, 黃志新, 等. AM L-1 /ETO 基因相關的AM L-M 2 型白血病免疫表型分析[J]. 中國實驗血液學雜志, 2007, 15(2): 378-381.
11.	Felicetto F, Rosa N, Mario A, et al. Immunophenotypic analysis enables the correct prediction of t (8; 21) in acute myeloid leukemia[J]. Br J Haematol, 1998, 102(2): 444-448.
12.	MacDonald AP, Janossy G, Ivo ry K, et al. Leukemia associated changes identified by quantitative flow cytometry CD34 over expression in acute myelogenous leukem ia M2 with t(8; 21)[J]. Blood. 1996, 87(4): 1162-68.
13.	Dunne J, Gascoyne DM, Lister TA, et al. AML1/ETO proteins control POU4F1/BRN3A expression and function in t(8;21) acute myeloid leukemia[J]. Cancer Res, 2010, 70(10): 3985-3995.
14.	Wang HW, Yang W, Shao H, et al. Complex t(2;21;8)(p12;q22;q22): a variant t(8;21) in a patient with acute myeloid leukemia (AML-M2) [J]. Cancer Genet Cytogenet 2009, 188(2): 95-98.
15.	Nguyen S, Leblanc T, Fenaux P, et al. A white blood cell index as the mainprognostic factor in t (8;21) acute myeloid leukemia (AML): a survey of 161 cases from the French AML Intergroup[J]. Blood, 2002, 99(10): 3517-3523.
16.	方艷紅, 劉紅星, 童春容, 等. 89例成人融合基因Aml1 / Eto陽性急性髓系白血病長期生存分析[J]. 中國實驗血液學雜志, 2009, 17(3): 750-755.
17.	Gorin NC, Labopin, Frassoni F, et al. Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t (8;21): a retrospective study from the European Cooperative Group for blood and marrow transplantation[J]. J Clin Oncol, 2008, 26(19): 3183-3188.
18.	Leblanc T, Berger R. Molecular cytogenetics of childhood acute myelogenous leukaemias[J]. Eur J Haematol, 1997, 599(1): 1-13.
19.	Schlenk RF, Benner A, Krauter J, et al. Individual patient data based meta-analysis of patients aged 16 to 60 years with core binding factor acutemyeloid leukemia: a survey of the German Acute Myeloid Leukemia Intergroup[J]. J Clin Oncol, 2004, 22(3): 3741-3750.
20.	貢金英, 劉旭平, 李承文, 等. 兩例急性髓系白血病伴t(6;21;8)(p22;q22;q22) 復雜易位患者的臨床與實驗室研究[J]. 中華血液學雜志, 2006, 27(5): 314-317.
21.	Byrd JC, Dodge RK, Carroll A, et al. Patients with t(8;21)(q22;q22) and acute myeloid leukemia have superior failure-free and overall survival when repetitive cycles of high-dose cytarabine are administered[J]. J Clin Oncol. 1999, 17(12): 3767-3775.
22.	Maria, Stewart CC, Lawrence D, et al. Expression of the neural cell adhesion molecule CD56 is associated with short remission duration and survival in acute myeloid leukemia with t(8;21)(q22;q22)[J]. Blood, 1997, 90(4): 1643-1648.
23.	Tawee Tanvetyanon, Sucha Nand, Amir A, et al. Allogeneic transplantation for acute myeloid leukemia (AML) M2 with translocation (8;21) and CD56 positivity is effective even for patients with relapsed disease[J]. Blood, 2004, 104: Abstract 5187.
24.	石紅霞, 江濱, 陸道培, 等. 成人t (8; 21)急性髓系白血病M2 型治療方案及預后分析[J]. 中華血液學雜志, 2005, 26(8): 481-484.

1. 　Prebet T, Boissel N, Reutenauer S, et al. Acute myeloid leukemia with translocation (8;21) or inversion (16) in elderly patients treated with conventional chemotherapy: a collaborative study of the French CBF-AML intergroup[J]. J Clin Oncol, 2009, 27(28): 4747-4753.
2. 　Groupe Français de Cytogénétique Hématologique. Acute myelogenous leukemia with an 8;21 translocation: a report on 148 cases from the Groupe Francais de Cytogénétique Hématologique[J]. Cancer Genet Cytogenet, 1990, 44(2): 169-179.
3. 　Han JS, Kim SH, Kwon HC, et al. A case of pathologic splenic rupture as the initial manifestation of acute myeloid leukemia M2[J]. Yonsei Med J, 2010. 51(1): 138-140.
4. 　Ferrara F, Vecchio. Acute myeloid leukemia with t(8;21)/AML1/ETO: a distinct biological and clinical entity[J]. Haematologica, 2002, 87(3): 306-319.
5. 　牧啟田, 陳志妹, 樓基余, 等. 154例t(8; 21)急性髓系白血病遺傳學分析[J]. 浙江大學學報(醫學版), 2010, 39(3): 236-240.
6. 　Yamasaki H, Era T, Asou N, et al. High degree of myeloid differentiation and granulocytosis is associated with t(8;21) smoldering leukemia[J]. Leukemia, 1995, 9(7): 1147-1153.
7. 　Bae SY, Kim JS, Ryeu BJ, et al. Acute myeloid leukemia (AML-M2) associated with variant t(8;21): report of three cases[J]. Cancer Genet Cytogenet, 2010, 199(1): 31-37.
8. 　Harris NL, Jaffe ES, Diebold J, et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting[J]. Clin Oncol, 1999, 17(12): 3835-3849.
9. 　Fleishma E, Sokova O, Popa AV, et al. Chromosomal translocation t(8, 21) in acute myeloid leukemia of children: prognostic value of additional karyotype abnormalities[J]. Vestn Ross Akad Med Nauk, 2009, 19(6): 9-16.
10. 　張建軍, 杜欣, 黃志新, 等. AM L-1 /ETO 基因相關的AM L-M 2 型白血病免疫表型分析[J]. 中國實驗血液學雜志, 2007, 15(2): 378-381.
11. 　Felicetto F, Rosa N, Mario A, et al. Immunophenotypic analysis enables the correct prediction of t (8; 21) in acute myeloid leukemia[J]. Br J Haematol, 1998, 102(2): 444-448.
12. 　MacDonald AP, Janossy G, Ivo ry K, et al. Leukemia associated changes identified by quantitative flow cytometry CD34 over expression in acute myelogenous leukem ia M2 with t(8; 21)[J]. Blood. 1996, 87(4): 1162-68.
13. 　Dunne J, Gascoyne DM, Lister TA, et al. AML1/ETO proteins control POU4F1/BRN3A expression and function in t(8;21) acute myeloid leukemia[J]. Cancer Res, 2010, 70(10): 3985-3995.
14. 　Wang HW, Yang W, Shao H, et al. Complex t(2;21;8)(p12;q22;q22): a variant t(8;21) in a patient with acute myeloid leukemia (AML-M2) [J]. Cancer Genet Cytogenet 2009, 188(2): 95-98.
15. 　Nguyen S, Leblanc T, Fenaux P, et al. A white blood cell index as the mainprognostic factor in t (8;21) acute myeloid leukemia (AML): a survey of 161 cases from the French AML Intergroup[J]. Blood, 2002, 99(10): 3517-3523.
16. 　方艷紅, 劉紅星, 童春容, 等. 89例成人融合基因Aml1 / Eto陽性急性髓系白血病長期生存分析[J]. 中國實驗血液學雜志, 2009, 17(3): 750-755.
17. 　Gorin NC, Labopin, Frassoni F, et al. Identical outcome after autologous or allogeneic genoidentical hematopoietic stem-cell transplantation in first remission of acute myelocytic leukemia carrying inversion 16 or t (8;21): a retrospective study from the European Cooperative Group for blood and marrow transplantation[J]. J Clin Oncol, 2008, 26(19): 3183-3188.
18. 　Leblanc T, Berger R. Molecular cytogenetics of childhood acute myelogenous leukaemias[J]. Eur J Haematol, 1997, 599(1): 1-13.
19. 　Schlenk RF, Benner A, Krauter J, et al. Individual patient data based meta-analysis of patients aged 16 to 60 years with core binding factor acutemyeloid leukemia: a survey of the German Acute Myeloid Leukemia Intergroup[J]. J Clin Oncol, 2004, 22(3): 3741-3750.
20. 　貢金英, 劉旭平, 李承文, 等. 兩例急性髓系白血病伴t(6;21;8)(p22;q22;q22) 復雜易位患者的臨床與實驗室研究[J]. 中華血液學雜志, 2006, 27(5): 314-317.
21. 　Byrd JC, Dodge RK, Carroll A, et al. Patients with t(8;21)(q22;q22) and acute myeloid leukemia have superior failure-free and overall survival when repetitive cycles of high-dose cytarabine are administered[J]. J Clin Oncol. 1999, 17(12): 3767-3775.
22. 　Maria, Stewart CC, Lawrence D, et al. Expression of the neural cell adhesion molecule CD56 is associated with short remission duration and survival in acute myeloid leukemia with t(8;21)(q22;q22)[J]. Blood, 1997, 90(4): 1643-1648.
23. 　Tawee Tanvetyanon, Sucha Nand, Amir A, et al. Allogeneic transplantation for acute myeloid leukemia (AML) M2 with translocation (8;21) and CD56 positivity is effective even for patients with relapsed disease[J]. Blood, 2004, 104: Abstract 5187.
24. 　石紅霞, 江濱, 陸道培, 等. 成人t (8; 21)急性髓系白血病M2 型治療方案及預后分析[J]. 中華血液學雜志, 2005, 26(8): 481-484.

《華西醫學》

急性髓系白血病伴t(8;21)的臨床特點及預后

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《華西醫學》

急性髓系白血病伴t(8;21)的臨床特點及預后

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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