慢性粒细胞白血病额外染色体异常在加速期和急变期的意义  

The Meaning of Additional Chromosomal Abnormalities in Chronic Myeloid Leukemia at Accelerated Phase and Blastic Crisis

作　　者：孙川 李倩[2] 林颖[3] 张亚文[4] 王伟[4] 

机构地区：[1]海南省农垦总医院肿瘤血液内科,570311 [2]温州医学院附属第二医院血液研究室,325003 [3]温州医学院附属第二医院血液科,325003 [4]吉林油田总医院检验科,138000

出　　处：《医学研究杂志》2014年第1期108-110,共3页Journal of Medical Research

摘　　要：目的探讨慢性粒细胞白血病（CML）的染色体变化在慢性期（CP）、加速期（AP）、急变期（BC）的特征，并分析遗传学变化对CML加速期、急变期的治疗和预后判断的意义。方法24—48h短期培养法，R显带，对63例患者的遗传学资料进行回顾性分析。结果63例中Ph染色体阳性61例（96．8％），Ph阴性但BCR／ABL阳性2例（3．2％），而61例Ph染色体阳性的患者中，典型Ph易位51例，非典型Ph染色体为10例（变异易位1例，伴有其他染色体平衡易位的4例，结构畸变2例，伴有超二倍体核型1例，双Ph1例，-Y1例），1例首诊为加速期，4例在1年内加速或急变。在51例典型Ph易位的患者中，5例形态学加速或急变，遗传学无额外染色体改变，6例遗传学出现额外染色体异常的同时或之后表现为加速或急变。结论染色体核型分析是CML诊断、临床分期及判断预后，指导治疗不可缺少的实验室指标，对预测CML加速、急变有重要的意义。Objective To study cytogenetic features of chromosome in chronic myelogenous leukemia （ CML）. To analyze the signif- icance of genetic alterations in diagnosis, treatment and prediction of prognosis at different stages of CML. Methods Chromosome for bone marrow or peripheral blood cells was prepared by 24 -48h short term culture. Analysis of genetic data were performed by R - band ing. Results Of 63 cases, 2 cases were detected Ph negative but BCR/ABL positive,61 cases were Ph chromosome（ 93. 85% ）. Of the 61 cases, 51 cases were detected typical Ph chromosome,and 10 patients had atypical Ph chromosome,including variant translocation in 1 case,with other chromosome balanced translocation in 4 cases, structural aberration in 2 cases, with hyperdiploid karyotype in 1 case, double Ph in 1 case, - Y in 1 case. The first diagnosis in 1 cases for accelerated phase, and 4 cases in 1 years to accelerated or blast cri- sis. In 51 patients with typical Ph, 5 patients without additional chromosome changes were morphological accelerated or blastic crisis,and 6 patients with additional chromosomal abnormalities of genetics at the same time or after were accelerated or blastic crisis. Conclusion Analysis of chromosome karyotypes was important laboratory index in prediction of prognosis of CML.

关 键 词：慢性粒细胞白血病 额外染色体异常 预后 

分 类 号：R733[医药卫生—肿瘤]