临床儿科杂志 ›› 2016, Vol. 34 ›› Issue (5): 321-.doi: 10.3969 j.issn.1000-3606.2016.05.001

• 血液肿瘤疾病专栏 •    下一篇

ETV6/RUNX1 阳性儿童急性B 系淋巴细胞白血病临床预后研究

王邢玮, 李本尚, 沈树红, 陈静, 汤静燕   

  1. 上海交通大学医学院附属上海儿童医学中心血液肿瘤科 国家卫生和计划生育委员会儿童血液肿瘤重点实验室 (上海 200127)
  • 收稿日期:2016-05-15 出版日期:2016-05-15 发布日期:2016-05-15
  • 通讯作者: 汤静燕 E-mail:tangjingyan@scmc.com.cn

Study on clinical prognosis among ETV6/RUNX1 positive childhood B-precursor acute lymphocyte leukemia

WANG Xingwei, LI Benshang, SHEN Shuhong, CHEN Jing, TANG Jingyan   

  1. Hematology & Oncology Department, Shanghai Children’s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, Key Laboratory of Pediatric Hematology & Oncology National Health and Fannily Planning Lommission, Shanghai 200127, China
  • Received:2016-05-15 Online:2016-05-15 Published:2016-05-15

摘要: 目的 探讨和验证ETV6/RUNX1融合基因在中国汉族B系急性淋巴细胞白血病(B-ALL)患儿中的阳性率及其对疾病预后的影响。方法 回顾性分析2007 年1 月1 日至2014 年12 月31 日确诊并序贯治疗的B-ALL患儿经FISH技术检测的ETV6/RUNX1融合基因结果及其临床资料。结果 共有723例B-ALL患儿,其中ETV6/RUNX1阳性B-ALL患儿151例,阳性率20.89%;在723 例B-ALL患儿中91 例患儿复发,其中ETV6/RUNX1阳性患儿复发10 例,占复发患儿的10.99%。同时,在ETV6/RUNX1阳性患儿中,除1例在诊断后65 d复发,其余9例的复发时间均超过300 d,复发时间中位数为1 155 d(P25 ~ P75= 395.3 ~ 1 301.5);ETV6/RUNX1阴性患儿复发时间为484 d(P25 ~ P75= 259.0 ~ 1 017.5),两组复发时间差异无统计学意义(P = 0.158)。对复发时间的分布区域分析发现,ETV6/RUNX1阳性患儿的复发期主要集中于临床化疗结束后,而阴性患儿的复发期主要集中于维持治疗期,两者的复发时间段分布差异有统计学意义(P < 0.001)。结论 ETV6/RUNX1在中国汉族儿童B-ALL中也是预后良好的标志之一。

Abstract: Objective To investigate the incidence of the ETV6/RUNX1 fusion gene among Chinese pediatric patients with B-ALL and its effect on the prognosis. Methods A total of 723 patients with B-ALL from January 1, 2007 to December 31, 2014 were enrolled in this study. All patients were detected ETV6/RUNX1 fusion gene by FISH. Clinical data and ETV6/RUNX1 were combined to analyze the clinical prognosis. Results Among the 723 patients, 151 were with ETV6/RUNX1 positive B-ALL, accounting for approximately 20.89% (151/723) of B-precursor cases; 91 patients were with recurrence, including 10 patients with ETV6/RUNX1 positive B-ALL, and the recurrence rate of ETV6/RUNX1 positive B-ALL was 10.99% (10/91). Among 10 recurrent patients with ETV6/RUNX1 positive B-ALL, 9 patients relapsed more than 300 days later after diagnosis, while the recurrence times among the patients with ETV6/RUNX1 negative was very different. Although the recurrence times between the two groups showed no significant difference (P = 0.09), the recurrence times of ETV6/RUNX1 positive patients were mainly found at the end of clinical chemotherapy, while the recurrence time of ETV6/RUNX1 negative patients were mainly at maintaining chemotherapy period, there was a significant difference between the distribution of recurrence time (P < 0.0001). Conclusions ETV6/RUNX1 fusion gene is a favorable predictor of outcome in Chinese pediatric B-ALL as well.