OBJECTIVETo delineate the clinical features and prognostic significance of acquired trisomy 21 (+21) in 31 patients with acute myeloid leukemia (AML).

METHODSChromosome specimen was prepared from bone marrow samples using a direct method and (or) cultivation, and their karyotypes were analyzed with R banding. The clinical features, chemotherapeutic effect and survival status of patients with acquired +21 were evaluated.

RESULTSCytogenetic studies were successfully performed on 3 329 patients with newly diagnosed AML, among which 31 (0.93%) had acquired +21. And 16 (0.48%) of the 31 patients had +21 as the sole abnormality. The most frequent subgroup of bone marrow morphology was AML-M5b, and its total number was 12 (38.7%) of the total. Thirty patients among those with +21 received standard chemotherapy. The complete remission (CR) rate (63% vs. 80%, P< 0.05) and median overall survival (OS) (7 months vs. 15 months, P< 0.01) of AML patients with acquired +21 were both lower than those without. Age (60 years or older) was associated with a significantly lower CR rate (30% vs. 80%, P< 0.05) and shorter median OS (4 months vs. 12 months, P< 0.01). Comparing to acquired +21 with other additional abnormalities, acquired +21 solely was associated with a lower median OS (6 months vs. 12 months, P< 0.05), but did not affect the CR rate (60% vs. 67%, P> 0.05). Three patients undergoing allogenetic hematopoietic stem cell transplantation (allo-HSCT) were still alive at the end of follow-up. Their survival time have reached 56, 36 and 105 months, respectively, which were remarkably longer than those only received chemotherapy (P< 0.01).

CONCLUSIONThe presence of acquired +21 in patients with AML has a adverse prognosis with or without other additional abnormalities. Older age (60 years or older) and +21 alone predicted relatively poorer outcome. Allo-HSCT was expected to prolong the survival time of AML patients with acquired +21.

Adolescent ; Adult ; Aged ; Chromosome Aberrations ; Down Syndrome ; genetics ; Female ; Humans ; Leukemia, Myeloid, Acute ; genetics ; Male ; Middle Aged ; Prognosis ; Young Adult

Microtus fortis is naturally resisitent to Schistosoma japonicum. In order to find schistosome-resistence-related genes of Microtus fortis, a T7 phage-display cDNA library from liver of Microtus fortis was screened with the soluble lysate of schistosomula. The specific phages were enriched 375-fold after 3 rounds of biopanning. Ninety-two positive clones picked at random were sequenced and 19 ESTs including 6 unreported genes were obtained. Compared with the negative phage clone control, five positive clones, No.4 (GenBank Accession No.: EW968294), No.13 (GenBank Accession No.: EW968303), No.14 (GenBank Accession No.: EW968304), No.15 (GenBank Accession No.: EW968305) and No.18 (GenBank Accession No.: EW968308) could induce significantly higher schistosomula mortality rate when co-cultivated with schistosomula. According to the function analysis and the shistosomula-killing effect in vitro, the genes encoding CASP8 and FADD-like apoptosis regulator isoform protein, alpha-2-HS-glycoprotein, M4 protein, R3H domain (binds single-stranded nucleic acids) isoform 2 and 3 previously unreported proteins (No.14, No.15 and No.18) obtained here, were schistosomiasis-resistence-related genes of Microtus fortis.
Animals ; Arvicolinae ; genetics ; parasitology ; Bacteriophage T7 ; genetics ; Cloning, Molecular ; Expressed Sequence Tags ; Gene Library ; Genes, Helminth ; genetics ; Immunity, Innate ; genetics ; Larva ; genetics ; growth & development ; Liver ; chemistry ; Schistosoma japonicum ; genetics ; growth & development