Molecular characteristics and clinical significance of 41 patients with acute promyelocytic leukemia

Objective To investigate the relationship of fusion gene characteristics and therapeutic efficacy,prognosis,survival in patients with acute promyelocytic leukemia (APL).Methods dynamicly PML-RARα and PLZF-RARα of 41 newly diagnosed APL patients were monitored with Q-PCR and analyzed.According to patients' fusion gene types,the time reaching complete molecular remission,the patients'survival time and rate were compared and analyzed.Results 29 of 41 newly diagnosed APL patients were observed PML-RARα-L positive,with a median age of 43 years old (8-75 years old),gene expression levels of (60.12±41.24) ％,and leukocyte median value of 2.1×109/L [(0.44-124)×109/L].11 of 41 cases were observed PML-RARα-S positive,with a median age of 34 years old (19-66 years old),gene expression levels of (24.36±25.72) ％,and leukocyte median value of 3.2×109/L [(0.47-88)×109/L],for just one patient,the gene expression level of PML-PLZF was 64.12 ％.The median time reaching complete molecular remission were 40 days (32-60 days) for L-type patients,and 56 days (25-86 days) for S-type patients,the event-free survival rate by 5-year follow-up were 100 ％ and 81.8 ％ for L-type and S-type,respectively (P =0.02).The PLZF-RARα-positive patient with C-KIT mutation didn' t have complete molecular remission,morphological relapse occurred two times within 18 months.Conclusions For APL patients with PML-RARα-L,thetherapeutic effect,prognosis,and event-free survival rate are better than APL patients with PML-RARα-S.APL patients with PLZF-RARα are prone to higher relapse and poor prognosis.It' s of high significance to evaluate the therapeutic efficacy and prognosis by detecting fusion gene and possible gene mutations for APL patients. Key words: Leukemia, promyelocytic, acute;  Fusion gene;  Therapeutic efficacy;  Prognosis