目的 探讨CD56和CD64对成人AML1/ETO+急性髓系白血病患者长期生存的影响.方法 回顾性分析35例成人AML1/ETO+急性髓系白血病患者的临床资料,应用Log-Rank检验和Cox回归模型对患者的性别、年龄、初诊时白细胞计数、免疫表型、首疗程是否完全缓解、c-kit基因突变、复杂核型、髓外白血病进行单因素和多因素综合分析.结果 35例患者随访3~87个月,中位随访时间33个月,单因素分析显示年龄、性别、髓外白血病、复杂核型、首疗程是否完全缓解、CD19、CD9对患者3年和5年总体生存率无显著影响(P>0.05),初诊时白细胞计数、CD56+、CD64+的表达对AML1/ETO+的长期生存具有显著性差异(P=0.045,P=0.044,P=0.045).多因素分析显示,CD56表达是影响AML1/ETO+急性髓系白血病患者长期生存重要的独立预后因素.其中CD56+CD64+显著影响患者长期生存(P=0.012).结论 CD56是AML1/ETO+急性髓系白血病患者独立的预后不良因素,且CD56+、CD64+双表达预后最差.%Objective To investigate the effects of CD56 and CD64 on long - term survival in patients with AML/ETO - positive acute myeloid leukemia. Methods An institutional retrospective study was performed on 35 AML/ ETO -positive acute myeloid leukemia patients from May 2010 to August 2016. Univariate and multifactorial analysis of potential factors influencing survival,including gender,age,initial WBC count,immunophenotype,chemotherapy course to com-plete remission (CR),c - kit gene mutation,complex karyotype and extramedullary leukemia,were carried out by using Log - rank test and Cox regression model. Results Thirty - five patients were followed up for 3 to 87 months (median 33 months). Univariate analysis showed that age,sex,extramedullary leukemia,complex karyotype,chemotherapy course to CR,CD19 or CD9 didn′t significanlty affect long - term survival,while initial WBC count,CD56 and CD64 were critical factors on it (P = 0. 045,P = 0. 044,P = 0. 045). Multivariate analysis showed that CD56 expression was an independent prognostic factor for AML/ ETO positive patients with acute myeloid leukemia. Patients with both CD56 positive and CD64 positive got the least long - term survival rate (P = 0. 012). Conclusion CD56 is an independent prognostic factor for AML/ ETO - positive acute myeloid leukemia patients,and CD56 and CD64 double - expression have the poorest prognosis.
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