Ph^+急性淋巴细胞白血病与慢性粒细胞白血病急淋变的比较研究  

Comparative clinical study of Philadelphia chromosome-positive acute lymphoblastic leukemia and lymphoid blast crisis of chronic myelogenous leukemia

作　　者：刘延方[1,2] 董慧[1,2] 孙慧[1,2] 孙玲[1,2] 万鼎铭[1,2] 姜中兴[1,2] 刘林湘[1,2] 陈绍倩[1,2] 谢新生[1,2] 程远东[1,2] 王芳[1,2] 孟小莉[1,2] 

机构地区：[1]郑州大学血液病研究所 [2]郑州大学第一附属医院血液科,郑州450052

出　　处：《医药论坛杂志》2012年第1期23-25,28,共4页Journal of Medical Forum

摘　　要：目的探讨Ph染色体阳性急性淋巴细胞白血病(Ph+ALL)与慢性粒细胞白血病急淋变的临床特点。方法对21例Ph+ALL患者及31例慢粒急淋变患者的临床资料进行回顾性对比分析。结果 Ph+ALL与慢粒急淋变有以下区别:①慢粒急淋变肝脾肿大发生率(80.65%)比Ph+ALL(14.28%)高(P<0.05);②起病时慢粒急淋变外周血白细胞数比Ph+ALL高(P<0.05);③Ph+ALL完全缓解率(76.19%)比慢粒急淋变(48.39%)高(P<0.05)。Ph+ALL的中位生存期为(10.76±6.91)个月,而慢粒急淋变的中位生存期为(7.06±6.03)个月,差异有统计学意义(P<0.05)。慢粒急淋变者完全缓解后Ph染色体持续存在,Ph+ALL患者完全缓解后Ph染色体消失。两组患者年龄、性别、骨髓中原始加幼稚细胞数差异均无统计学意义(P>0.05)。结论 Ph+ALL与慢粒急淋变具有不同的临床特点及治疗反应。Objective To explore the clinical features of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia（Ph＋ALL） and with chronic myeloid leukemia in lymphoid blast crisis（CML LBC）.Methods Retrospective analysis of the clinical data of 21 cases of Ph＋ALL and 31 cases of CML LBC.Results Comparing with Ph＋ALL patients,CML LBC patients showed following clinical features： ① The incidence of splenomegaly and hepatomegaly（80.65%）was higher than that of Ph＋ALL（14.28%）（P0.05）.② The white blood cell count was higher than that of Ph＋ALL（P0.05）.③ The complete remission rate（CR）（48.39%） was lower than that of Ph＋ALL（76.19%）（P0.05）.The median survival time of patients with Ph＋ALL was（10.76±6.91） months,which was significantly longer than that of CML LBC（7.06±6.03）months,（P0.05）.Philadelphia chromosome was still present in bone marrow cells after patients with CML LBC reached complete remission,but it was negative in patients with Ph＋ALL.There was no significant differences between the two groups with regard to age,sex,the bone marrow progenitor cells and immature cells（P0.05）.Conclusions Paitents with Ph＋ALL and CML LBC present with different clinical features and therapeutic response.

关 键 词：PH染色体 急性淋巴细胞白血病 慢性粒细胞白血病 急淋变 

分 类 号：R733.7[医药卫生—肿瘤]