261例急性髓系白血病的WHO分型  

WHO classification of 261 patients with acute myeloid leukemia

作　　者：邵英起[1] 刘世和[1] 徐世才[1] 徐泽锋[1] 李睿[1] 邱录贵[1] 郝玉书[1] 肖志坚[1] 

机构地区：[1]中国医学科学院中国协和医科大学血液学研究所血液病医院,天津300020

出　　处：《白血病．淋巴瘤》2005年第3期129-132,共4页Journal of Leukemia & Lymphoma

基　　金：国家自然科学基金资助(30270573)

摘　　要：目的对急性髓系白血病(AML)患者的WHO分型系统进行评价。方法对按FAB标准确诊并进行了染色体核型分析和/或AML特异相关融合基因检测的259例AML和21例RAEB蛳t患者,重新分类计数其血片和骨髓片,按WHO标准回顾性进行分型诊断,并进行了按WHO标准分型诊断后各亚型之间的诱导化疗疗效比较。结果21例RAEB蛳t患者中2例按WHO标准重新诊断为AML。AML伴(t8;21)/AML1蛳ETO与按国内AML标准确诊的M2b、AML伴t(15;17)/PML蛳RARα与M3/M3v、AML伴inv(16)(p13q22)或t(16;16)(p13;q22)/CBFB蛳MYH11与M4Eo的吻合率为100%。21例(11.2%)的患者重新归入AML伴有多系发育异常。AML伴t(8;21)/AML1蛳ETO和AML伴inv(16)(p13q22)或t(16;16)(p13;q22)/CBFB蛳MYH11患者的诱导化疗CR率显著高于不另做分类的AML患者(P<0.05)。有多系增生异常患者的诱导化疗CR率明显低于无多系增生异常患者(P<0.05)。结论AML的WHO分型各亚型的一致性及与临床疗效相关性较FAB分型更好。Objective To explore the WHO classification of acute myeloid leukemia(AML). Methods An unselected series of 259 patients with AML and 21 patients with MDS RAEB- t who were previously classified according to FAB criteria and had cytogenetic and acute myeloid leukemia specific fusion genes data were reclassified with WHO classification. The complete remission(CR) rate of induce chemotherapy are compared between subgroups classified according to WHO criteria. Results 2 of the 21 RAEB- t cases were reclassified as AML. All of the M2b, M3/M3v and M4Eo were reclassied as AML with t(8;21)/ AML1- ETO, AML with t(15;17) /PML- RARα and AML with inv(16)(p13q22) or t(16;16) (p13; q22) /CBFB- MYH11, respectively. 21 of the 261 patients (11.2 %) cases were reassigned to the category of acute myeloid leukemia with multilineage dysplasia. The CR rate of induce chemotherapy of patients with AML with t(8;21)/AML1- ETO and AML with inv(16) (p13q22) or t(16;16) (p13; q22) /CBFB- MYH11 were significantly higher than patients with normal karyotype and other chromosome abnormalities (P < 0.05). The CR rate of induce chemotherapy of the patients with AML with multilineage dysplasia following MDS were significantly lower than other patients (P < 0.05). Conclusions The homogeneous and the correlation between the subgroups and treatment response of the WHO criteria defined subgroups of AML is better than the FAB criteria defined subgroups.

关 键 词：白血病 髓细胞性 急性 诊断 WHO分型 

分 类 号：R733.7[医药卫生—肿瘤]