探讨小核仁RNA（snoRNA）SNORA63在急性白血病（AL）患者骨髓中的表达水平及其对AL患者临床诊断、治疗和预后的意义。 53例初诊AL患者和29例患者的骨髓样本收集2018年3月至2021年12月广东医科大学附属医院的健康受试者。采用实时定量聚合酶链反应（qRT-PCR）检测两组骨髓单个核细胞中SNORA63的相对表达水平。以AL患者中SNORA63的中位表达水平为界值，将患者分为SNORA63高表达组和低表达组，分析SNORA63表达水平与AL患者临床特征、临床指标及预后的关系。 AL患者中SNORA63的相对表达水平显着低于健康对照组[0.3018(0.0244-1.2792) vs 1.0882(0.2797-1.9889)](P < 0.01)。初次治疗后未缓解的 AL 患者中 SNORA63 的表达水平显着低于健康对照和完全缓解（CR）患者（P < 0.01），而治疗后未缓解的 AL 患者中 SNORA63 的表达水平差异无统计学意义。 AML 和 ALL 组（P >0.05）。 SNORA63 异常低表达与 AL 患者发热、出血、预后不良、疗效、血小板（PLT）、乳酸脱氢酶（LDH）、白蛋白（ALB）及分子生物学异常密切相关（P < 0.05），但与与性别、年龄、AL亚型、苍白、疲劳、髓外浸润、白细胞计数（WBC）、血红蛋白（HGB）、C反应蛋白（CRP）、降钙素原（PCT）、纤维蛋白原（FIB）或染色体核型显着相关（P>0.05）。同时，SNORA63高表达组AL患者的总生存期（OS）和无事件生存期（EFS）显着高于SNORA63低表达组（P < 0.05）。单因素Cox回归分析显示，SNORA63、分子生物学异常、发热、PLT和LDH是影响AL患者OS和EFS的因素（P < 0.05）。多因素Cox回归分析显示，发热、分子生物学异常和LDH是与AL患者OS和EFS相关的独立因素（P < 0.05）。SNORA63在AL患者中显着下调表达，是一个具有重要临床价值的分子标志物。 AL 患者的疾病监测和预后评估。

To investigate the expression level of small nucleolar RNA (snoRNA) SNORA63 in bone marrow of patients with acute leukemia (AL) and its significance in the clinical diagnosis, treatment and prognosis of AL patients.Bone marrow samples of 53 newly diagnosed AL patients and 29 healthy subjects in the Affiliated Hospital of Guangdong Medical University from March 2018 to December 2021 were collected. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect the relative expression level of SNORA63 in bone marrow mononuclear cells of the two groups. The median expression level of SNORA63 in AL patients was used as the boundary value to divide the patients into SNORA63 high and low expression groups, and the relationship between the expression level of SNORA63 and the clinical characteristics, clinical indicators and prognosis of AL patients was analyzed and discussed.The relative expression level of SNORA63 in AL patients was significantly lower than that in healthy control group [0.3018 (0.0244-1.2792) vs 1.0882 (0.2797-1.9889)] (P < 0.01). The expression level of SNORA63 in AL patients without remission after initial treatment was significantly lower than that in healthy controls and the patients who received complete remission (CR) (P < 0.01), while there was no statistical difference in the expression level of SNORA63 between AML and ALL groups (P >0.05). The abnormal low expression of SNORA63 was closely related to fever, hemorrage, poor prognosis, efficacy, platelets (PLT), lactate dehydrogenase (LDH), albumin (ALB), and molecular biological abnormalities of AL patients (P < 0.05), but not significantly correlated with sex, age, AL subtype, pallor, fatigue, extramedullary infiltration, white blood cell count (WBC), hemoglobin (HGB), C-reactive protein (CRP), procalcitonin (PCT), fibrinogen (FIB) or chromosome karyotype (P >0.05). Meanwhile, overall survival (OS) and event-free survival (EFS) of AL patients in SNORA63 high-expression group were significantly higher than those in SNORA63 low-expression group (P < 0.05). Univariate Cox regression analysis showed that SNORA63, molecular biological abnormalities, fever, PLT and LDH were the factors influencing OS and EFS in AL patients (P < 0.05). Multivariate Cox regression analysis indicated that fever, molecular biological abnormalities and LDH were independent factors associated with OS and EFS in AL patients (P < 0.05).SNORA63 is significantly down-expressed in AL patients, which is a molecular marker of great clinical value for disease monitoring and prognosis evaluation in AL patients.