Đặc điểm kiểu hình miễn dịch và mối liên quan với đáp ứng điều trị ở bệnh nhi lơ xê mi cấp dòng tủy điều trị tại Viện Huyết học - Truyền máu Trung ương=Immunophenotyping characteristics and the correlation with treatment outcome in pediatric patients with acute myeloid leukemia treated at the National Institute of Hematology and Blood Transfusion

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Tác giả: Thị Hưng Dương, Thị Hồng Hoàng, Thị Nguyệt Lê, Lan Mai, Hà Thanh Nguyễn, Hồng Sơn Nguyễn, Quỳnh Mai Trần, Thu Thủy Trần

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.196-207

Bộ sưu tập: Metadata

ID: 478234

Thêm vào giỏ

Describe the immunophenotypic characteristics in pediatric patients with acute myeloid leukemia, comment on some treatment results and initially study the relationship between immunophenotypic characteristics and treatment results of pediatric acute myeloid leukemia at the National Institute of Hematology and Blood Transfusion in the period 2019-2022. Subjects: 148 pediatric patients with acute myeloid leukemia (AML) in the 4 years 2019- 2022. Research method: Cross-sectional description. Results: The ratio of male/female is about 1.2/1
the average age is 8.4 years old. AML M4 and M2 account for the highest rates at 36.49% and 35.14%, respectively. The most common myeloid marker is CD33, positive in 95.9%, while CD13 only accounts for 51.4%
MPO occurs in 78,4% of cases. The monocyticlineage markers, CD64, had a positive rate of 33.8%. Markers showing maturation properties were CD34 positive in 77%, CD117 in 89.2% and HLA-DR in 88.5%. The most common lymphocyte lineages markers are CD56 and CD7 with rates of 29.13% and 25.7%. Pediatric patients with MPO (+) had significantly longer OS and PFS than the MPO (-) (35.6 and 33.4 months vs. 25.4 and 23.9 months, p 0.016 and 0.02). The CD19 (+) patient group had longer OS and PFS than the CD19 negative group with 45.0 and 45.2 months vs 31.4 and 29.0 months, p 0.008 and 0.003, respectively). The group of patients with CD34(+)/HLA-DR (-) had a significantly worse response rate than the group without this immunophenotype (40.0% vs 89.4%, p= 0.001) and had shorter PFS compared to the remaining patients (18.3 and 32.3 months, p = 0.038). Conclusion: The most common myeloidspecific markers were CD33 (95.9% of patients) and MPO (78.4% of patients)
CD34 positive in 77%, CD117 in 89.2% and HLA-DR in 88.5%. The most common heterologous markers were CD56 and CD7 (29.13% and 25.7%). MPO (+) was associated with significantly longer OS and PFS than the MPO negative group with 35.6 and 33.4 months compared to 25.4 and 23.9 months (p = 0.016 and 0.02). The CD34(+)/HLA-DR(-) group of patients had a significantly poorer response rate than the group without this immunophenotype (40.0% vs. 89.4%, p= 0.001) and had a shorter PFS than the remaining patients (18.3 vs. 32.3 months, p= 0.038).Mô tả đặc điểm kiểu hình miễn dịch ở bệnh nhi (BN) lơ xê mi cấp dòng tủy, nhận xét một số kết quả điều trị và bước đầu tìm hiểu mối liên quan giữa đặc điểm kiểu hình miễn dịch và kết quả điều trị lơ xê mi cấp dòng tuỷ trẻ em tại Viện Huyết học - Truyền máu Trung ương giai đoạn 2019- 2022. Đối tượng: 148 bệnh nhi lơ xê mi cấp dòng tủy (AML) trong 4 năm 2019- 2022. Phương pháp nghiên cứu: Mô tả cắt ngang. Kết quả: Tỷ lệ bệnh nhi nam/nữ mắc AML là khoảng 1,2/1
độ tuổi trung bình là 8,4 tuổi. Lơ xê mi cấp dòng tủy thể M4 và M2 chiếm tỷ lệ cao nhất lần lượt là 36,49% và 35,14%. Dấu ấn đặc hiệu dòng tủy phổ biến nhất là CD33, dương tính 95,9% trường hợp, trong khi CD13 lại chỉ chiếm có 51,4%
MPO gặp ở 78,4% số trường hợp. Dấu ấn dòng mono, CD64 có tỷ lệ dương tính 33,8%. Các dấu ấn thể hiện đặc tính non hóa, CD34 dương tính ở 77%, CD117 là 89,2% và HLA-DR là 88,5%. Dấu ấn khác dòng hay gặp nhất là CD56 và CD7 dương tính với tỷ lệ 29,13% và 25,7%. Nhóm bệnh nhi có MPO (+) có OS và PFS dài hơn đáng kể so với nhóm MPO (-) (35,6 và 33,4 tháng so với 25,4 và 23,9 tháng, p là 0,016 và 0,02). Nhóm bệnh nhân có CD19 (+) có OS và PFS dài hơn so với nhóm CD19 âm tính với 45,0 và 45,2 tháng so với 31,4 và 29,0 tháng
p lần lượt là 0,008 và 0,003). Nhóm bệnh nhân có CD34(+)/HLA-DR (-) có tỉ lệ đáp ứng kém hơn đáng kể với nhóm không có kiểu hình miễn dịch này (40,0% so với 89,4%
p= 0,001) và có PFS ngắn hơn so với các bệnh nhân còn lại (18,3 và 32,3 tháng
p = 0,038). Kết luận: Dấu ấn đặc hiệu dòng tủy phổ biến nhất là CD33 (95,9% BN) và MPO (78,4% BN). Các dấu ấn thể hiện đặc tính non hóa, CD34 dương tính ở 77%, CD117 là 89,2% và HLA-DR là 88,5%. Dấu ấn khác dòng hay gặp nhất là CD56 và CD7 (29,13% và 25,7%). MPO (+) có liên quan với OS và PFS dài hơn đáng kể so với nhóm MPO âm tính với 35,6 và 33,4 tháng so với 25,4 và 23,9 tháng (p = 0,016 và 0,02). Nhóm bệnh nhân có CD34(+)/HLA-DR(-) có tỉ lệ đáp ứng kém hơn đáng kể với nhóm không có kiểu hình miễn dịch này (40,0% so với 89,4%
p=0,001) và có PFS ngắn hơn so với các bệnh nhân còn lại (18,3 và 32,3 tháng
p = 0,038).

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