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Objective@#To evaluate the clinical characteristics and prognosis of 3q26 rearrangements in chronic myeloid leukemia (CML) patients. @*Methods@#The clinical and laboratory data of 1 075 patients with CML diagnosed from 2010 to 2016 were retrospectively analyzed, and they were divided into 3q26 rearrangement positive group (n=19) and 3q26 rearrangement negative group (n=1 056). The expression of EVI1, ABL kinase region mutation and survival time between the two groups were compared. Meanwhile, the prognostic effects of three treatment methods, including tyrosine kinase inhibitors (TKIs), TKIs combined with chemotherapy and allogeneic hematopoietic stem cell transplantation, on the patients with 3q26 rearrangements were compared. @*Results@#Most of the patients with 3q26 rearrangements were in the advanced phase (χ 2 =181.233, P＜0.01), and the median time to enter the acute phase was shorter (9.5 months). The mutation ratio of ABL kinase region and expression levels of EVI1 in 3q26 rearrangement positive group were significantly higher than that in the negative group (χ 2 =16.758, P＜0.01; Z/U=-0.331 9, P＜0.01). After treatment with TKIs, the median survival time of the 3q26 rearrangement positive group was significantly shorter than that of the negative group (χ 2 =313.229, P＜0.01). The prognosis of the patients treated with hematopoietic stem cell transplantation was better than that with TKIs (P=0.049). @*Conclusion@#The CML patients with 3q26 rearrangements have a higher risk of sudden change, shorter survival time and poor prognosis. Hematopoietic stem cell transplantation may improve their prognosis.
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Objective To investigate the clinical features and the efficient therapy of acute promyelocytic leukemia(APL)with high initial white blood cell(WBC)count.Methods The clinical features of 66 newly diagnosed APL patients with high initial WBC and 152 patients without high initial WBC from the First Affiliated Hospital of Soochow University between October 1993 and August 2006 were retrospectively analyzed.Additionally,66 patients with high WBC were divided into different groups according to the different induction therapy and the therapeutic effects were compared.Results The early death rate and the incidence of disseminated intravascular coagulation(DIC)and retinoic acid syndrome(RAS)were 30.3%,57.6% and 31.8% respectively for the group with high initial WBC,which were higher than the indexes of 7.2%,38.1% and 21.05% respectively for the group without high initial WBC(P