Adult T(8;21) Clinical Analysis Of Acute Myeloid Leukemia

Objective:To evaluate the results of 56 adult patients with t（8;21）clinical data analysis of AML patients,discussion of t（8;21）the clinical features and prognostic factors of AML provide the basis for accurate treatment of t（8:21）AML.Methods:A retrospective analysis of 56 cases of adults admitted to our hospital from January2012 to June 2017 was t（8;21）in patients with AML,collect patients’gender,age,routine blood,bone marrow cytology,immune phenotype,chromosome karyotype,such as clinical data,Uses the IA（E）,DA（E）or the CAG scheme for induction therapy and evaluation after chemotherapy in patients with complete remission（CR）rate,analysis of factors affecting CR rate.After remission,the Ara-c regimen of IA（E）,DA（E）,HA,or medium and large dose was successively strengthened for 6⁸ courses,and long-term follow-up of patients’total survival time was discussed the clinical features of t（8;21）AML and its prognostic factors.Results1.General features:A total of 56 cases of t（8;21）AML patients were included in this study,median age 42（18⁷4）years old.Among them,36 cases（64.3%）and 20 females（35.7%）were female,male:female=1.8:1.M0 1（1.7%）,M1 3（5.4%）,M2 42（75%）,M4 8（14.3%）,and M5（3.6%）.Anemia in 48 cases,lack of 43 cases,fever 20 cases,26 cases were bleeding,superficial lymph node enlargement,15 cases of bone pain in 10 cases,hepatomegaly 22 cases,splenomegaly 12 cases,1 cases of orbital chloroma,testicular infiltration in 1 case,central nervous infiltration in 2 cases.During the initial diagnosis,peripheral blood WBC5.50（0.61¹44.37）×10⁹/L,Hb 80（37¹23）g/L,Plt 72（43³20）×10⁹/L.Which WBC≥10×10⁹/L with anemia and thrombocytopenia in 22 cases,WBC<10×10⁹/L with anemia and thrombocytopenia in 21 cases. T（8;21）of 56 patients 30 cases of abnormal patients（53.6%）,t（8;21）26 patients with additional nuclear type（46.4%）.Immune phenotypic detection of bone marrow cells,more than70%of the patients with bone marrow leukemia cells express CD33,CD13,CD34,HLA-DR,CD117,such as cell surface antigen,CD19+patients 29 cases（51.8%）,CD56+25 cases（44.6%）patients.Line of genetic testing,56 patients with the highest frequency is C-KIT gene mutation24 cases（42.9%）,respectively,in turn,FLT3-ITD 21 cases（37.5%）,ASXL1 11 cases（19.6%）of the NRAS 10 cases（17.9%）.2.CR rate and its influencing factors:After a course of treatment,CR₁41 cases,CR₁ rate73.2%,2 courses of CR₂ 50 cases,CR₂ rate accumulated to 89.3%.Compare patients’gender,age,both the white blood cells,primitive bone marrow cells,chromosome karyotype and induction programme,the influence of CR rate after a period of treatment to patients,only age<60 patients with CR rate is significantly higher than age 60 or more patients,the difference was statistically significant（p<0.05）.3.OS rate and its influencing factors:median follow-up time:26（0⁶0）months.In the initial diagnosis,the white blood cells were more than 10 x 10⁹/L,CD56+,C-Kit,FIT3-ITD,NRAS,and Y chromosome were lost to the patients with poor prognosis,and CD19 positive was a good prognostic factor for the patients.Multivariate analysis:the number of white blood cells,C-Kit,NRAS gene mutation and Y chromosome loss in the initial diagnosis werethe independent prognostic factors of OS in t（8;21）AML patients.Conclusion1.T（8;21）AML is good for the M2 type of patients,and the primary diagnosis is anemia,bleeding and fever.2.T（8;21）patients with AML were significantly higher than those aged 60 and older.There was no significant effect on CR rate in patients with peripheral blood leukocyte,bone marrow primordial cell proportion,chromosome karyotype and induction program.3.During the initial diagnosis,the white blood cells were more than 10 x 10⁹/L,CD56+,C-Kit,FIT3-ITD,NRAS,and Y chromosome loss to t（8;21）the prognosis of AML patients was poor,and CD19 positive was a good prognostic factor.In addition,the number of white blood cells,C-Kit,NRAS gene mutation and Y chromosome loss werethe independent prognostic factors ofOS in t（8;21）AML patients.