| ObjectiveTo collect the clinical datas and assay index of patients who were newly diagnosed with acute myeloid leukemia in the past two years in the Second Hospital of Shanxi Medical University, to follow them to learn the state of disease by phone. To endeavour to get knowledge of the relationship between CD56 antigen expression and clinical features and laboratory parameters, and to detect if the expression of CD56 antigen affect the prognosis. Meanwhile the factors that affecting the prognosis of AML were also analyzed. It is to offer clinical evidence for a more general understanding of CD56 positive AML. Methods1.Checking the laboratory and treatment datas of newly diagnosed AML patients of the Second Hospital of Shanxi Medical University from August 2013 to August 2015 in the medical records room and on the electronic medical records system,Following the current situation of the disease by phone.2.Dividing the AML patients into CD56 positive and CD56 negative groups, analyzing the differences of clinical datas and the main laboratory parameters of the two groups.3. Analyzing the disease-free survival of the two groups.4. Making Univariate and multivariate analysis of DFS of the AML patients. Results1.A total of 151 cases of AML patients were embraced in the study,including 49 cases(32.5%) of CD56 positive ones, and 102 cases(67.5%) of negative ones.There were statistical significances that the proportion of male in CD56 positive group is higher than that of CD56 negative group( 63.39% vs 49.02%,P=0.018),while no statistical significances were found in age and extramedullary infiltration.2.No statistical significances were detected in certain aspects of CD56 positive group and CD56 negative group, such as white blood cell(WBC) counts, hemoglobin(HGB), platelet(PLT) counts, Lactate dehydrogenase(LDH), Hydroxybutyric acid dehydrogenase(HBDH), ? 2- microglobulin( ? 2-MG), karyotype and gene mutation.In chromosomal abnormalities analysis, the occurrence rate of t(8;21) in the two groups showed statistical differences(P=0.009).3.Up to August 2015,the complete remission rate and relapse rate of 151 patients with AML showed no statistical differences in the two groups divided according to the expression of CD56.In APL group and non-APL group, the complete remission rate?relapse rate and disease-free survival time showed no statistical differences. According to the risk status in NCCN Guidelines Version1.2015 Acute Myeloid Leukemia, there were favorable-risk group, intermediate-risk group and poor-risk group..In intermediate-risk group, the complete remission rate,the relapse rate and one year disease-free survival rate indicated no statistical differences in the two groups divided according to whether the patients express CD56 antigen or not, but the two years disease-free survival rate showed significant differences between the two groups(0 % vs 32.3%,P=0.0125). Similar results were not found in the remaining two groups.4.The univariate analysis showed that it were WBC count, HGB(30-60 g / L) and with t(15; 17) chromosomal abnormalities that effect the prognosis of AML. Multivariate analysis revealed that WBC count(<3.5×109 /L or>50×109/L) is a independent adverse risk factor and t( 15; 17) chromosomal abnormalities is a independent prognostic protective factor. Conclusion1.Compared with CD56 negative group of patients with AML, CD56 positive group of patients are more likely to be associated with t(8; 21) chromosomal abnormalities.2.According to the risk status in NCCN Guidelines Version1.2015 Acute Myeloid Leukemia, in intermediate-risk group, patients with CD56 expression had a lower two years disease-free survival rate. CD56 antigen expression in AML may predict an unfavorable prognosis.3.The count of WBC(<3.5×109 /L or>50×109/L) is a independent adverse factor for AML.4.AML with t(15;17)chromosomal abnormalities is a independent prognostic protective factor. |
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