CD38表达对成人BCR/ABL融合基因阳性急性B淋巴细胞白血病预后的影响-东南大学学报医学版

CD38表达对成人BCR/ABL融合基因阳性急性B淋巴细胞白血病预后的影响

单位：徐州医科大学淮安临床学院血液内科, 江苏淮安 223300

分类号：R733.71

出版年·卷·期（页码）：2020·39·第六期（737-741）

摘要：

目的：探讨急性B淋巴细胞白血病（B-ALL）患者白细胞分化抗原38（CD38）表达与疗效及预后的关系。方法：收集2014年至2017年在我院初诊的B-ALL患者共74例，用流式细胞仪检测患者骨髓白血病细胞免疫表型，实时荧光定量PCR检测断裂点簇基区-Abelson酪氨酸激酶（BCR-ABL）融合基因。分别依据CD38表达强度分为CD38⁺组和CD38^-组以及BCR-ABL融合基因存在与否分为BCR-ABL⁺组和BCR-ABL^-组，回顾性分析不同组别患者的临床资料及预后。结果：74例B-ALL患者中，CD38⁺组和CD38^-组患者分别为34例及40例，BCR-ABL⁺组和BCR-ABL^-组分别为30例及44例。BCR/ABL⁺组患者CD38表达率显著低于BCR/ABL^-组（26.7%vs 73.3%，P=0.017）。CD38⁺和CD38^-患者的总生存期（OS）及无进展生存期（PFS）差异无统计学意义。BCR/ABL⁺患者中，CD38⁺组的中位OS和PFS显著低于CD38^-组（15.73个月vs 25.8个月，9.27个月vs 25.8个月；分别P=0.01和P=0.021）；而BCR/ABL^-患者中，CD38⁺组和CD38^-组的中位OS和PFS差异均无统计学意义。结论：CD38表达是BCR/ABL⁺ALL患者预后不良的因素，即使酪氨酸酶抑制剂（TKI）治疗也不能改变这种不良预后。

Objective: To investigate the prognostic role of CD38 expression in B-cell acute lymphoblastic leukemia(B-ALL). Methods: A total of 74 patients with newly diagnosed B-ALL in our hospital between 2014 and 2017 were enrolled. Immunophenotype of leukemic cells and breakpoint cluster region(BCR)-Abelson tyrosine kinase(ABL) fusion gene were assayed by flow cytometry and quantitative real-time PCR,respectively. Parients were divided into CD38⁺ and CD38^- groups based on their CD38 expression,and then subdivided into BCR-ABL⁺ and BCR-ABL^-groups based on their BCR-ABL fusion gene status. The clinical characteristics and prognosis of different groups were analyzed retrospectively. Results: CD38 expression of the BCR-ABL⁺ALL(30 cases) group was significantly lower than that of the BCR-ABL^-ALL group(44 cases)(26.7% vs 73.3%,P=0.017). There was no statistical difference of overall survival(OS) and progression free survival(PFS) between CD38⁺(34 cases) and CD38^-(40 cases) groups. However,the median OS and PFS of CD38⁺ patients was significantly lower than that of CD38^- patients in the BCR-ABL⁺ subgroup(15.73 month vs 25.8 months,9.27 months vs 25.8 months; P=0.01,P=0.021),while there was no statistical difference of the median OS and PFS between CD38⁺ and CD38^- patients in the BCR/ABL^-subgroup. Conclusion: CD38 expression is a factor for poor prognostic in BCR/ABL⁺ ALL patients,and this poor prognostic could not be overcome by tyrosinase inhibitor(TKI) treatment.

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