摘要目的 探讨急性早幼粒细胞白血病(APL)附加染色体异常及t(15;17)的临床意义.方法 回顾性分析2007年1月至2014年6月青岛大学附属医院收治的90例初治APL患者的临床特点及染色体资料.根据染色体核型的不同分为附加仅数目改变组(16例)、附加仅结构异常组(14例)、附加数目改变和结构异常组(4例)以及典型染色体组(56例).按照是否含有t(15;17)分为含有t(15;17)组(82例)和不含有t(15;17)组(8例).分析比较各组近期疗效及生存情况.结果 附加仅数目改变组、附加仅结构异常组、附加数目改变和结构异常组以及典型染色体组的完全缓解率分别为56.3%(9／16)、100.0%(14／14)、25.0%(1／4)和82.1%(46／56),早期的死亡率分别为25.0% (4／16)、0(0／14)、75.0%(3／4)和8.9%(5／56),其中附加数目改变和结构异常组完全缓解率低,早期死亡率高,与其他组比较,差异均有统计学意义(均P＜0.05).含有t(15;17)组和不含有t(15;17)组完全缓解率分别为80.5%(66／82)和50.0%(4／8),差异无统计学意义(P＝0.070).结论 染色体核型同时存在附加数目和结构改变的APL患者完全缓解率低,早期死亡率高,预后不良.含有t(15;17)的患者完全缓解率较高.

abstractsObjective To investigate the clinical significances of additional chromosome abnormalities and t(15;17) in acute promyelocytic leukemia (APL). Methods A total of 90 newly diagnosed APL patients in the Affiliated Hospital of Qingdao University from January 2007 to June 2014 were analyzed retrospectively. Patients with different chromosome karyotypes were divided into four groups: additional chromosome number abnormalities group (16 cases), additional chromosome structural abnormalities group (14 cases), additional chromosome number and structural abnormalities group (4 cases) and typical chromosome group (56 cases). According to whether the patient contained t(15;17), the patients were divided into group with t(15;17) and group without t(15;17). The short﹣term efficacy and survival of each group were analyzed and compared. Results The rate of complete remission in additional chromosome number abnormalities group, additional chromosome structural abnormalities group, additional chromosome number and structural abnormalities group and typical t(15;17) chromosome changes group were 56.3% (9/16), 100.0% (14/14), 25.0% (1/4) and 82.1% (46/56), the early mortality rates were 25.0% (4/16), 0 (0/14), 75.0% (3/4) and 8.9% (5/56) respectively. Among them, the additional number and structural abnormalities group had lower complete remission rate and higher early mortality rate, and compared with other groups, the differences were statistically significant (all P < 0.05). The complete remission rates of the group with t(15;17) and the group without t(15;17) were 80.5% (66/82) and 50.0% (4/8), respectively, and the difference was not statistically significant (P ＝ 0.070). Conclusions APL patients with karyotypes with additional number and structural changes have low complete remission rate, high early mortality rate and poor prognosis. Patients with t(15;17) have a high rate of complete remission.