Risk stratification and analysis of prognostic factors of acute myeloid leukemia with t(8;21) / 白血病·淋巴瘤

ABSTRACT

Objective To investigate the cytogenetic and immunological phenotypes of acute myeloid leukemia (AML) with t(8;21),and explore the risk stratification and risk-adapted treatments.Methods The chromosomal karyotype of bone marrow was detected and analyzed in 22 newly diagnosed patients with t(8;21) AML by direct culture and G banding technique.Patients were divided into two groups according to the chromosomal karyotypes.Clinical characteristics and immunological phenotypes were compared between patients with isolated t(8;21) and those with additional aberrations.A follow-up study with median time 30 months (4-68 months) was conducted to analyze prognostic factors.Results 13 cases (59.1％) were isolated t(8;21) AML,while 9 (40.9 ％) had additional aberrations.Loss of sex chromosome was found in 3 cases and complex variant translocation in 2.The 10q-,9q-,-18 and +10 were found in single cases.Overall survival of patients with additional aberrations was significantly poorer than those with isolated t (8;21) (P =0.0176).Analysis of prognostic factors showed that t(8;21) chromosomal karyotype,initial white blood cells at diagnosis,and treatment regimen (chemotherapy alone or plus hematopoietic stem cell transplantation) had effects on overall survival.Conclusion Patients with t (8;21) AML are frequently associated with additional chromosomal aberrations.The latter indicates a poorer outcome and can be one of the bases of risk stratification.Hematopoietic stem cell transplantation might help to improve the overall survival.