The clinical study on children acute lymphoblastic leukemia with different fusion gene by multiplex RT-PCR / 中华检验医学杂志

ABSTRACT

Objective To elevate the prevalence of fusion gene in children with acute lymphoblastic leukemia(ALL),and compare the difference in the clinical characteristics and prognosis of children with ALL carrying different fusion genes.Methods The results of fusion gene that detected by multiplex RT-PCR in children with 341 newly diagnosed ALL between July 2013 and December 2016 in West China Second University Hospital,Sichuan university were retrospectively reviewed.Date of clinical characteristics, morphology, immunophenotype, cytogenetic characteristics and event-free survival were collected and analyzed by χ2test and survival analysis in different groups according the results of fusion genes.Results The positive rate of fusion genes was 35.2%(120/341),including 69 cases with TEL-AML1,16 cases with E2A-PBX1,16 cases with BCR-ABL,10 cases with MLL gene rearrangement,5 cases with HOX11L2 and 4 cases with SIL-TAL1.There was statistical difference in age of different fusion gene groups(χ2=29.552, P<0.05),most of children carrying TEL-AML1,E2A-PBX1 were younger than 5 years,but carrying BCR-ABL,MLL gene rearrangement were opposite.The children with BCR-ABL,MLL gene rearrangement or SIL-TAL1 had higher WBC and severer enlarged liver, spleen and lymph node(χ2=27.657,45.822,P<0.05).There also had statistical difference in morphology and immunophenotype in fusion gene groups(χ2=31.333,P<0.05).TEL-AML1,E2A-PBX1 and BCR-ABL were mainly found in B-ALL,HOX11L2 and SIL-TAL1 were only found in T-ALL,but MLL gene rearrangement were found in both.The survival analysis showed that the event-free survival(EFS)in groups of BCR-ABL and MLL gene rearrangement were lower than other groups(χ2=15.368,P<0.05), but there was no significant difference in T-ALL(χ2=1.592, P>0.05).Conclusions Fusion gene detection is an important molecular marker in ALL of children.The ALL children with different fusion genes have different clinical features, immunophenotype and prognosis.