EVI1基因在儿童急性髓细胞白血病中的表达及意义 .pdfVIP

EVI1基因在儿童急性髓细胞白血病中的表达及意义

郑晨钰;温贤浩;郭玉霞;管贤敏;于洁;肖剑文

【摘要】目的探讨EVI1基因表达与儿童急性髓细胞白血病(AML)临床表现及预

后的关系.方法检测AML患儿EVI1基因表达,分析EVI1阳性AML患儿临床和实

验室检查特点以及预后.结果145例AML患儿中EVI1阳性38例,占26.21%.与阴

性组相比,阳性组患儿的年龄、性别、血红蛋白量、白细胞及血小板计数、细胞形

态学FAB分型、异常核型检出率差异均无统计学意义(P0.05);阴性组复杂核型检

出率高于阳性组,差异有统计学意义(χ2=5.50,P=0.019).38例阳性患儿中,14例化

疗与7例异基因造血干细胞移植(allo-HSCT)患儿的无事件生存(EFS)率差异有统计

学意义(χ2=4.00,P=0.045).阳性组与阴性组患儿化疗完全缓解率差异无统计学意

义(91.67%对91.18%,P0.05),阳性组患儿复发率高于阴性组,差异有统计学意义

(64.29%对22.22%,P=0.009);两组EFS率差异也有统计学意义

(χ2=5.76,P=0.015).2例阳性组患儿骨髓复发时EVI1基因仍阴性.结论EVI1基因

是儿童AML的不良预后因素,allo-HSCT可改善EVI1阳性AML患儿预后.定量检

测EVI1基因表达可能不适用于微小残留病监测.%ObjectiveToinvestigatethe

relationshipbetweenEVI1geneexpressionandclinicalfeaturesand

prognosisofchildrenwithacutemyeloidleukemia(AML).MethodsEVI1

genewasdetectedinAMLchildren,correlationofclinicalandlabfeatures,

prognosisofAMLchildrenwithEVI1genewereanalyzed.ResultsEVI1

expressionispositivein38of145childrenwithAML.Therewereno

significantdifferencesinage,gender,hemoglobinconcentration,

leukocytesandplateletcount,subtypeofmorphology,ratioof

chromosomalanomalyandcomplexkaryotypesbetweenEVI1positiveand

EVI1negativegroup(P0.05);coexistgenesweredetectedin9cases

(23.68%)ofEVI1positivegroup.Rateofcompleteremission(CR)was91.67%

in24casesofEVI1positivepatientsreceivedchemotherapy.Relapserate

was64.29%and14.29%inEVI1positivepatientswhoreceived

chemotherapyandallo-hematopoieticstemcelltransplantation(allo-

HSCT),retrospectivelyandsignificantdifferenceswerefound(P0.05).

TherewasnosignificantdifferenceinCRbutsignificantdifferencewas

foundineventfreesurvival(P0.05)forEVI1positiveandEVI1negative

patientswhoreceivedchemotherapy.EVI1genekeptnegativewhenbone

marrowrelapseoccurredintwopatientswithEVI1positi