浅议与APL预后密切相关的因子

急性早幼粒细胞白血病(APL)是急性髓系白血病(AML)的一种特殊亚型。近年来随着全反式维甲酸和三氧化二砷的靶向治疗日益规范化,APL的预后已很大程度上得到提高,成为AML中预后最好的亚型,但仍有15%的患者发生复发。越来越的学者致力于研究影响APL预后的因素,以往很多人们关注过的因子在近来的研究中也发现在APL中起着重要的作用,如FLT3、CD56、Fas等,以及新近证实的一些特殊基因的表达也影响着APL的预后,BAALC低表达与APL预后正相关,与其相反Ets相关基因(ERG)高表达与APL预后负相关。在此本文总结了近年来人们在APL预后研究的进展,这些因素的发现,使人们对APL发病机制有了更深一层的了解,便于临床上早期对APL患者进行危险分层,对高风险的APL患者采用个体化治疗,也可成为日后治疗APL的新靶点。

Factors Closely Associated with the Prognosis of APL

Acute promyelocytic leukemia(APL) is a special type of acute myeloid leukemia(AML). Since all-trans retinoic acid (ATRA) and arsenic trioxide have been used in APL successfully, the prognosis of APL has improved a lot, which makes it the best type of leukemia, but there are still 15% patients to whom relapse may occur. More and more people focus on the factors which affect the prognosis of APL. They have found many factors known to us before now play an important role in APL, for example: FLT3, CD56, Fas. A lot of genes also affect the prognosis of this disease. Low BAALC expression has been shown to be associated with a superior outcome in APL, on the contrary, high ERG expression maintained its value as an independent negative prognostic factor of APL. Here we summarize the progress people have made these years. These findings help us to understand the pathogenesis of APL, to improve risk classification in APL and to develop more individualized treatment strategies for high-risk APL patients, and in the future they may become the new therapeutic targets.