The Korean Journal of Medicine

  • 제81권4호
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  • Pages.517-525
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  • 2011
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

c-kit 돌연변이가 동반된 RUNX1/RUNX1T1 양성 급성골수성백혈병에서의 골수육종

Myeloid Sarcoma in Patients with RUNX1/RUNX1T1 Positive AML and a c-kit Mutation

  • 윤유선 (가톨릭대학교 의과대학 내과학교실) ;
  • 최승화 (가톨릭대학교 의과대학 내과학교실) ;
  • 유선홍 (가톨릭대학교 의과대학 내과학교실) ;
  • 유진석 (가톨릭대학교 의과대학 내과학교실) ;
  • 이지은 (가톨릭대학교 의과대학 내과학교실) ;
  • 김희제 (가톨릭대학교 의과대학 내과학교실) ;
  • 민우성 (가톨릭대학교 의과대학 내과학교실)
  • Yun, Yu-Seon (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Choi, Seung-Hwa (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Yoo, Sun-Hong (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Yu, Jin-Sok (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Lee, Ji-Eun (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Kim, Hee-Je (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine) ;
  • Min, Woo-Sung (Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea School of Medicine)
  • 발행 : 2011.10.01
⟨ 이전 논문 다음 논문 ⟩

초록

RUNX1-RUNX1T1 양성 AML에서 c-kit 돌연변이와 골수외 백혈병의 발생은 밀접한 상관관계가 있으며 고식적 치료법에 저항성을 나타내고 궁극적으로 매우 나쁜 예후를 보인다. 그러므로 임상적으로 골수외 백혈병이 동반된 AML 환자에서 c-kit 돌연변이 여부를 확인하고 고위험군으로 분류하여 더욱 적극적인 치료를 시행해야겠다. 저자들은 최근 t (8;21)(q22;q22);RUNX1-RUNX1T1 양성 AML 환자에서 c-kit 유전자 돌연변이와 골수외 백혈병이 동반된 3예를 임상 경험하여 문헌고찰와 함께 보고하는 바이다.

t (8;21)(q22;q22) is the most frequently detected cytogenetic abnormality in patients with acute myeloid leukemia (AML) and accounts for 8-21% of de novo AML. The translocation involves two genes, RUNX1 (formerly AML1) on 21q22 and RUNX1T1 (ETO) on 8q22. RUNX1/RUNX1T1 translocation confers a favorable prognosis, but a subset of patients has a precipitous course with a high incidence of relapse. This patient subset is associated with the presence of a c-kit mutation. c-kit is a proto-oncogene, which encodes a type III transmembrane tyrosine kinase, which elicits a variety of cellular responses essential for the development of bone marrow stem cells. The expression of the c-kit mutation in AML is < 2%, whereas AML with RUNX1/RUNX1T1 shows higher rates of c-kit mutation and is associated with extramedullary leukemia and poor clinical outcome. We report cases of myeloid sarcoma in patients with RUNX1/RUNX1T1-positive AML and a c-kit mutation.

키워드

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