Chromosome,molecular genetic abnormalities,and survival analysis of 148 adults patients with acute leukemia
10.7683/xxyxyxb.2024.09.006
- VernacularTitle:成人急性白血病148例染色体、分子遗传学异常及生存分析
- Author:
Peipei YING
1
;
Yuhu FENG
Author Information
1. 安徽医科大学附属阜阳人民医院血液科,安徽 阜阳 236000
- Keywords:
acute leukemia;
chromosome;
molecular genetic analysis;
survival analysis
- From:
Journal of Xinxiang Medical College
2024;41(9):833-839
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the chromosome,molecular genetic abnormalities and survival prognosis of adults with acute leukemia(non-M3 type).Methods A total of 148 adult patients with acute leukemia who visited the Department of Hematology of Fuyang People's Hospital from December 2019 to December 2022 were selected as the research subjects.The chromosome karyotype and molecular genetic characteristics of the patients were detected and analyzed by using chromosome banding analysis techniques(R-banding)and fluorescence in situ hybridization.The general information,laboratory examina-tions and prognosis of the patients were collected from the medical records and questionnaires of the subjects.The Kaplan-Meier method was used to draw the survival curve.The survival analysis was tested by the Log-Rank method.Results Among the 148 adult patients with acute leukemia,62 developed acute lymphoblastic leukemia(ALL),with the majority of subtypes being B,and 86 developed acute myeloid leukemia(AML),with the majority of subtypes being M2 and M5.Bone marrow chromosome examination was successfully performed in 141 patients,and there was no significant difference in the proportion of abnormal bone marrow chromosome karyotypes between AML patients and ALL patients(x2=1.864,P＞0.05).A total of 143 patients completed fusion gene examination,and the results showed that 28 of 81 AML patients were fusion gene positive,including 8 cases(9.87％)of mixed lineage leukemia-rearranged(MLL-R)fusion gene,and 20 of 62 ALL patients were fusion gene positive,including 6 cases(9.68％)of MLL-R fusion gene.The incidence of hepatosplenomegaly was significantly higher in patients with positive MLL-R than in patients with negative MLL-R(x2=3.645,P＜0.05),and the incidence of elevated peripheral leukocyte count(≥100 x 109 L-1)was also higher in patients with positive MLL-R than in patients with negative MLL-R(x2=7.051,P＜0.05).The incidence of abnormal bone marrow chromosome karyotype was higher in patients with positive MLL-R than in patients with negative MLL-R(x2=13.961,P＜0.05).There was no significant difference in leukemia typing,age,gender,platelet count and hemoglobin level between patients with positive MLL-R and those with negative MLL-R(P＞0.05).In the ALL group,there was no significant difference in remission rate,relapse rate and mortality rate between MLL-R positive and MLL-R negative patients(P＞0.05);in the AML group,there was no significant difference in remission rate,relapse rate and mortality rate between MLL-R positive and MLL-R negative patients(P＞0.05).There was no significant difference in mortality rate between leukemia patients who received chemotherapy and bone marrow stem cell transplantation(P＞0.05).The 1-year event free survival(EFS)rates of ALL and AML patients were(41.90±3.20)％and(38.20±2.20)％,respectively,and there was no significant difference in the 1-year EFS rate between the ALL and AML patients(x2=0.512,P＞0.05).The 1-year overall survival(OS)rates of ALL and AML patients were(60.50±4.20)％and(58.20±4.60)％,respectively,and there was no significant difference in the 1-year OS rate between the ALL and AML patients(x2=0.175,P＞0.05).The 1-year EFS rates of MLL-R positive and MLL-R negative patients were(34.60±2.70)％and(36.20±3.10)％,respectively,and there was no significant difference in the 1-year EFS rate between the MLL-R positive and MLL-R negative patients(x2=0.579,P＞0.05).The 1-year OS rates of MLL-R positive and MLL-R negative patients were(37.30±4.20)％and(56.60±5.20)％,respectively,and there was a significant difference in the 1-year OS rate between the MLL-R positive and MLL-R negative patients(x2=4.092,P＜0.05).Conclusion There is no significant difference in abnormal chromosome karyotype between AML and ALL patients.The fusion gene MLL-R can be found in both AML and ALL patients.Although MLL-R positive patients are more likely to have hepatosplenomegaly,abnormal chromosome karyotype and elevated leukocyte count,the efficacy shows no significant difference between MLL-R positive patients and negative patients.The current treatment for AML and ALL patients is mainly chemotherapy.Although MLL-R negative patients have better 1-year OS rates than MLL-R positive patients,there is no significant difference in the 1-year EFS rate between MLL-R positive and MLL-R negative patients.
