骨髓活检在白血病造血干细胞移植中的应用价值探讨  

THE STUDY OF BONE MARROW BIOPSY FOR AUTOLOGOUS HEMATOPOITIC STEM CELL TRANSPLATATION OF ACUTE LEUKEMIA

作　　者：牛俊杰 畅立铭 裴福生 胡治黄 钱裕民 曲垣瑞 

机构地区：[1]运城市第三医院血液科,山西运城044000

出　　处：《白血病．淋巴瘤》2004年第4期212-213,共2页Journal of Leukemia & Lymphoma

摘　　要：目的:探讨骨髓活组织检查在白血病自体造血干细胞移植(AHSCT)中的应用价值。方法:对23例白血病患者,在自体造血干细胞移植(AHSCT)前常规采用一步法,于髂后上棘进行抽吸涂片及活检取材,骨髓涂片进行常规检验,活体标本给予塑料包埋剂包埋,染色采用Wright、HGF或改良HGE染色。结果:23例患者骨髓涂片均获得CR,原始细胞比例≤5 %,而骨髓切片14例仍未获CR,占60.9 %。涂片原始细胞占2.2 %~4.6 %者6例,此组标本中切片原始细胞簇多见,且为大簇或片状分布。切片获CR者为9例,AHSCT后CR期时间为3 a ~ 13 a,平均为8 a,其中2例已分别生存13 a、12 a。结论:骨髓活检的CR为真正的CR,此时进行AHSCT,预后较好。此方法对于白血病进行AHSCT前的残留白血病细胞检测,具有方便、快捷、价格低廉的优点,值得推广。Objective: To study the value of bone marrow biopsy(BMB) for autologous hematopoitic stem cell transplatation(AHSCT) of acute leukemia(AL). Methods: Before AHSCT for 23 cases of AL to draw materials from their iliums, that to be made by bone marrow smearing(BMS), and plastic investing, then to be cut sections for microscopic examination. To stained with HGF or HGE and Wright- Gemsa. Results: All the 23 cases BMS showed complete remission(CR). The rate of blastocytes≤5 %. But 14 of 23(60.9 %) cases were unremissiooned on bone marrow biopsy section(BMBS). The rate of blastocytes was 2.2 % - 4.6 % of 6 cases on BMS, that blast clusters were more than the others, and were bigger or appeared lamllar distribution. On the 9 cases of BMS were complete remissioned, the disease free survival(DFS) after HSCT, that were 3 years^13 years, ave rage time were 8 years. And the DFS of 2 of 9 cases(22 %) were 13 years to 12 years. Conclusion : The CR of BMBS was true CR. Then began to AHSCT, it may be acecific value on determining the residule blastocyes. Because of its simple and convenient, so it is worth to spread.

关 键 词：骨髓活检 白血病 AHSCT 残留白血病细胞 

分 类 号：R733.7[医药卫生—肿瘤]