Clinical Index Analysis Of Acute Promyelocytic Leukemia With PML/RARa-negative Detected By FISH

ABSTRACTObjective:Through the analysis of FISH-negative PML/RAR? group of acute promyelocytic leukemia(APL) with clinical index of atypical and typical signal groups, in order to improve the FISH-negative PML/RAR? of APL in early diagnostic rate and avoid missed diagnosis, timely targeted therapy, improve clinical alertness.Methods: In March 2010 to August 2015 in The First Affiliated Hospital of Nanchang university, adults hospitalized with APL treated first clinical data of 110 patients were retrospectively analyzed. According to the result of FISH detection technique will be divided into the negative PML/RAR? group, atypical signal and typical signal groups, contrast analysis of clinical index between groups, respectively.Results:110 cases with APL treated first, negative group is 14 cases, atypical signal group is 19 cases, group of 77 cases of typical signal, clinically relevant index comparison between groups as follows:1.Groups of patients in gender, age, white blood cells, hemoglobin, platelet, bone marrow promyelocytic percentage, the initial degree of hyperplasia of the bone marrow, lactate dehydrogenase, fibrinogen, 3P no statistical difference(P > 0.05).2.Coagulation index: prothrombintime(PT): negative groups PT was 12.35±1.68 seconds, atypical signal group PT was 15.54 ±6.07 seconds, typical signal group PT was 12.62±2.20 seconds; there was a significant statistic difference in average value of PT between the Atypical signal group and the typical signal group(P = 0.032 < 0.05), is no statistic difference in others. activated partial thromboplastin time(APTT) : negative group APTT was 26.95 ±4.66 seconds, atypical signal group APTT was 29.16 ±7.44 seconds, typical signal group APTT was 25.96±5.19 seconds; Atypical signal group compared with the typical signal group in APTT have a statistically significant difference(P = 0.034 < 0.05), is no statistical significance between the other groups.3.Chromosome karyotype: negative groups have normal karyotype in the majority, accounted for 77.8%; 46.7% of the atypical signal karyotypes were complex karyotype; Typical signal group of typical karyotype t(15; 17) is accounting for 69%;Comparison between groups have statistically significant difference(P < 0.01).4.Induction therapy for the first time: negative groups: 1 case not to recheck the bone marrow cytology for economic factor, CR 12 cases, accounted for 92.3%; NR 1 case. Atypical signal groups: CR 18 cases, accounted for 94.7%; PR 1 case. Typical signal groups: CR 77 cases, accounted for 100%. Comparison between groups have no statistical significance(P > 0.05), but the typical signal group response rate is higher.Conclusions:1. The negative group and atypical signal and typical signal between groups, hemogram, coagulation indexes, myelogram, lactate dehydrogenase were no statistically significant difference.2.Compared to atypical signal with the typical signal group in PT, APTT, the atypical signal group for a long time, the difference was statistically significant(P<0.05).3.Conventional chromosome examination negative groups have normal karyotype in the majority, atypical signal group complex karyotype is given priority to, typical signal groups of typical karyotype of APL primarily, there are statistically significant differences(P<0.05).4.The typical signal group treated first complete remission rate higher than negative group, a typical signal.