具有不同融合基因的B系急性淋巴细胞白血病患儿的临床特征分析

左英熹, 张乐萍, 陆爱东, 王彬, 刘桂兰

中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (3) : 172-176.

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中国当代儿科杂志 ›› 2010, Vol. 12 ›› Issue (3) : 172-176.
论著·临床研究

具有不同融合基因的B系急性淋巴细胞白血病患儿的临床特征分析

  • 左英熹,张乐萍,陆爱东,王彬,刘桂兰
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Clinical characteristics of children with B cell type acute lymphoblastic leukemia carrying different fusion gene

  • ZUO Ying-Xi, ZHANG Le-Ping, LU Ai-Dong, WANG Bin, LIU Gui-Lan
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摘要

目的:分析具有不同融合基因的B系急性淋巴细胞白血病(acute lymphoblastic leukemia, ALL)患儿的临床特征、分子遗传学特征与免疫分型和预后之间的差异。方法:总结2006年3月至2008年12月北京大学人民医院儿科收治的B系ALL患儿80例,其中TEL/AML1阳性组18例、E2A/PBX1阳性组14例、BCR/ABL阳性组11例、MLL/AF4阳性组2例及4种融合基因均阴性的患儿35例,总结其临床特征、形态学、免疫分型及分子生物学、染色体等相关资料,并分析各组患儿的无病生存率(DFS),随访时间至2009年4月。结果:TEL/AML1阳性组中,年龄≤5岁的患儿占66.7%,发病时的肿瘤负荷不高,形态学以FAB-L2型多见,而染色体核型均未见t(12;21)的异常,长期预后好,至今有17例患儿达到无病生存;14例 E2A/PBX1阳性组中,女性患儿多见,其中13例患儿形态学表现为FAB-L1型,12例患儿的免疫分型为前B细胞型,DFS接近80%;11例BCR/ABL阳性患儿中10例免疫分型为普通B细胞型,FAB-L1 和L2 型各4例。DFS不足20%;而MLL/AF4阳性的2例患儿发病时肿瘤负荷均高,形态学均为FAB-L1型,免疫分型均为早前B细胞型。1例化疗早期放弃治疗,另1例至今已无病生存达21个月。结论:具有不同融合基因的患儿,其临床特征、免疫分型及预后等方面具有显著差异。[中国当代儿科杂志,2010,12(3):172-176]

Abstract

OBJECTIVE: To investigate whether there were differences in the clinical characteristics, cytogenetic characteristics, immunophenotype and prognosis in children with B cell type acute lymphoblastic leukemia (B-ALL) carrying different fusion genes. METHODS: The research included 80 children with B-ALL from Peking University People’s Hospital between March 2006 and December 2008. Eighteen children were positive for TEL/AML1, 14 for E2A/PBX1, 11 for BCR/ABL,and 2 cases for MLL/AF4, and 35 cases were negative for all of the 4 fusion genes. Data including clinical characteristics, morphology, immunophenotype and cytogenetic characteristics were collected, and the disease-free survival (DFS) was evaluated. The children were followed up until April 2009. RESULTS: In the 18 children with TEL/AML1+B-ALL, 66.7% were younger than 5 years old. They had low tumor load. FAB-L2 morphology was commonly observed, but t(12;21) was often absence in these children. Up to now,17 children who survived were disease-free. In the 14 children with E2A/PBX1+B-ALL, the majority were female. Thirteen children showed FAB-L1 morphology. Twelve children showed pre-B-ALL immunophenotype. The EFS was close to 80%. In the 11 children with BCR/ABL+B-ALL, 10 children showed common B type immunophenotype. FAB-L1 and FAB-L2 morphology was found in 4 children respectively. The DFS was less than 20%. Two children with MLL/AF4 positive B-ALL had high tumor load. Their morphologic diagnosis was FAB-L1. Both showed the Pro-B-ALL immunophenotype. One child discontinued treatment at the early stage of chemotherapy, and the other child survived disease-free until now. CONCLUSIONS: The B-ALL children with different fusion genes have different clinical characteristics, immunophenotypes and prognosis.[Chin J Contemp Pediatr, 2010, 12 (3):172-176]

关键词

急性淋巴细胞白血病 / 融合基因 / 儿童

Key words

Acute lymphoblastic leukemia / Fusion gene / Child

引用本文

导出引用
左英熹, 张乐萍, 陆爱东, 王彬, 刘桂兰. 具有不同融合基因的B系急性淋巴细胞白血病患儿的临床特征分析[J]. 中国当代儿科杂志. 2010, 12(3): 172-176
ZUO Ying-Xi, ZHANG Le-Ping, LU Ai-Dong, WANG Bin, LIU Gui-Lan. Clinical characteristics of children with B cell type acute lymphoblastic leukemia carrying different fusion gene[J]. Chinese Journal of Contemporary Pediatrics. 2010, 12(3): 172-176
中图分类号: R733.71   

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