11q23异常成人急性白血病临床及实验室特征分析  

Clinical and laboratory studies on adult acute leukemia with 11q23 abnormalities.

作　　者：魏辉[1] 林冬[1] 秘营昌[1] 刘旭平[1] 刘世和[1] 卞寿庚[1] 王建祥[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实验血液学国家重点实验室,天津300020

出　　处：《中国实用内科杂志》2008年第5期368-370,共3页Chinese Journal of Practical Internal Medicine

基　　金：天津市科技发展计划资助(05YFSZSF02400)

摘　　要：目的研究11q23异常成人急性白血病(AL)的实验室资料与其临床特征和预后的关系。方法对1992年8月至2003年11月中国协和医科大学血液学研究所收治的23例11q23异常的成人AL的临床和实验室资料进行回顾性分析。结果23例11q23异常的患者中14例为急性髓性白血病(AML),7例为急性淋巴细胞白血病(ALL),1例为急性杂合细胞白血病(HAL),1例为急性未分化白血病(AUL)。AML中以AML-M4及AML-M5为主,ALL中以前B-ALL为主。异常核型主要为11q23缺失(n=9)和t(4;11)(n=8)。23例AL的中位存活时间为175d,14例AML的中位存活时间为185d,7例ALL的中位存活时间为167d。结论11q23异常AL在成人主要见于AML-M4及AML-M5和前B-ALL,具有高白细胞、易于髓外浸润、化疗缓解率低、预后差等临床特点,为预后不良的细胞遗传学改变。Objective To investigate the interrelations among morphology,immunology, cytogenetics and clinical outcome in adult acute leukemia with 11q23 abnormalities. Methods From August 1992 to November 2003,23 patients who suffered from acute leukemia with 11q23 abnormalities in State Key Laboratory of Experimental Hematology and Blood Diseases Hospital, Institute of Hematology, CAMS ＆ PUMC, were retrospectively analysed for clinical and laboratory data. Re- sults The 23 cases included 14 acute myeloid leukemia（AML） ,7 acute lymphoblastic leukemia（ALL） ,1 hybrid acute leukemia and 1 acute undifferentiated leukemia. Most of AML were AML-M4/M5 and most of ALL were Pro-B-ALL. Karyotype analysis disclosed 7 abnormalities altogether, mainly del （ 11 cases ） （ q23 ） （ 9 cases ） and t （ 4 ; 11 ） （ 8 cases ）. The median survival time was 175 days for 23 AL, 185 days for 14 AML and 167 days for 7 ALL. Conclusion Most adult patients with 11q23 abnormalities are more often seen in acute monocytic leukemia and Pro-B-ALL with unique features, including high white blood count, extramedullary involvement, lower CR rates and poor prognosis. The 11q23 abnormalities are unfavorable cytogenetics.

关 键 词：染色体畸变 11q23 白血病 免疫表型 

分 类 号：R5[医药卫生—内科学]