Objective: To investigate the clinical prognostic factors of initially-treated AML children with t(8;21)/RUNX1-RUNX1T1+.
Methods: Clinical data of 41 initially-treated AML children with t(8;21)/RUNX1-RUNX1T1+ in our hospital in period from January 2009 to January 2017 were retrospectively analyzed. The baseline clinical characteristics, cumulative recurrence, event-free survival (EFS) and overall survival (OS) were recorded, and the influencing factors of prognosis were evaluated by χ2 test and Cox regression model.
Results: The complete remission (CR) rates in the first course and the second course of induction chemotherapy were respectively 82.93% (34/41) and 97.56% (40/41). The median EFS time and OS time were 30 months and 31 months respectively. The EFS rate and OS rate of children with CR after the first treatment course were significantly higher than those of children without CR (P＜0.05). The EFS rate of male children was significantly higher than that of female children (P＜0.05). The OS rate of children < 10 years old was significantly higher than that of children≥10 years old (P＜0.05). The expression level of RUNX1-RUNX1T1 gene after the second induction remission was the influencing factor of cumulative recurrence rate, EFS rate and OS rate in children (P＜0.05). Multivariate analysis by Cox regression model showed that the decreased levels of RUNX1-RUNX1T1 gene expression < 3 log after the second induction remission was the independent risk factor for EFS rate and OS rate in children (P＜0.05). The cumulative recurrence rate of children with RUNX1-RUNX1T1 gene expression increase for＞1 log after decreased 3 log was significantly higher than that of children with≤1 log (P＜0.05).
Conclusion: Iuithally-treated AML children with t(8;21)/RUNX1-RUNX1T1+ show the fine clinical prognosis after standard chemotherapy. The expression level of RUNX1-RUNX1T1 gene should be closely relates with the recurrence and long-term survival of AML children.
题目: 合并t（8;21）/RUNX1-RUNX1T1+初治AML患儿预后影响因素分析.
目的: 探讨合并t（8;21）/RUNX1-RUNX1T1+初治急性髓系白血病（AML）患儿预后影响因素.
方法: 回顾性分析本院2009年1月-2017年1月收治合并t（8;21）/RUNX1-RUNX1T1+初治AML患儿41例临床资料, 记录基线临床特征、累积复发、无事件生存及总生存情况, 并通过χ2检验和Cox回归模型评价预后影响因素.
结果: 41例患儿行诱导方案化疗后首个疗程和第2个疗程完全缓解率分别为82.93%（34/41）和97.56%（40/41）；中位无事件生存时间和总生存时间分别为30和31个月。首个疗程达完全缓解患儿无事件生存率和总生存率显著高于未达完全缓解患儿（P＜0.05）；男性患儿无事件生存率显著高于女性患儿（P＜0.05）；发病年龄＜10岁患儿总生存率显著高于≥10岁患儿（P＜0.05）。第2次诱导缓解后RUNX1-RUNX1T1基因表达水平是患儿累积复发率、无事件生存率及总生存率影响因素（P＜0.05）；Cox回归模型多因素分析显示, 第2次诱导缓解后RUNX1- RUNX1T1基因表达下降＜3 log 是影响患儿无事件生存率和总生存率独立危险因素（P＜0.05）；同时RUNX1-RUNX1T1基因表达下降3 log水平后升高＞1 log水平患儿累积复发率显著高于≤1 log水平患儿（P＜0.05）.
结论: 合并t（8;21）/RUNX1-RUNX1T1+初治AML患儿行规范化疗后临床预后良好, RUNX1-RUNX1T1基因表达水平与AML患儿复发及远期生存密切相关.