t(16;21）（p11；q22）急性髓系白血病九例报告并文献复习

OBJECTIVE: To analyze the biological and clinical characteristics of acute myeloid leukemia (AML) with t(16;21) (p11;q22), and the curative effect and prognosis. METHODS: A retrospective study was conducted in nine cases with AML with t(16;21) (p11;q22) from January, 2009 to December, 2014 in People's Hospital of Peking University. RESULTS: Of 1 372 AML patients, 9 cases with t(16;21) (p11;q22), 4 males and 5 females, were identified. According to the FAB classification, 1 case was classified as M(1), 5 as M(2), 1 as M(4), 2 as M(5). Three patients have morphological cavity at the time of diagnosis. Immunophenotypic features showed the positive CD117, CD13, CD33 and CD34, especially CD56. 5 cases were identified as complex karyotype abnormalities, besides from t(16;21) (p11;q22). All cases could be detected TLS/FUS-ERG fusion genes. 9 cases acquired complete remission (CR) after chemotherapy. 2 cases were only treated with chemotherapy and relapsed after 5 months and 16 months, and died at 10 months and 27 months after diagnosis. 7 of 9 cases accepted allogeneic hematopoietic stem cell transplantation (allo-HSCT) after chemotherapy, the median survival for 21 months (11–46 months). Summarized the 42 cases of adult AML with t(16;21) (p11;q22) from literature, 27 cases with chemotherapy alone, 15 cases underwent HSCT, the median survival for 10 (95% CI 1–17) months and 18(95% CI 2–76) months, respectively. The difference was statistically significant (P<0.001). CONCLUSION: AML with t(16;21) (p11;q22) was rare, it has a special form and distinct immunophenotypic characteristics and poor prognosis, allo-HSCT could improve the prognosis and should be considered after CR.