砷剂治疗急性早幼粒细胞白血病过程中细胞形态学及遗传学变化  

A serial study of in cytogenetic change and morphology on the tetra-arsenic tetra-sulfide treatment in untreated or recurrent acute promyelocytic leukemia

作　　者：刘辉[1] 邱镜滢[1] 陆道培[1] 洪波[1] 史惠琳[1] 师岩[1] 党辉[1] 何琪[1] 

机构地区：[1]北京大学医学部人民医院血液病研究所细胞遗传室

出　　处：《中华肿瘤杂志》2003年第2期163-167,共5页Chinese Journal of Oncology

摘　　要：目的　观察四硫化四砷 (TATS)治疗初治和复发急性早幼粒细胞白血病 (APL)过程中细胞形态学及细胞遗传学变化 ,探讨其作用机制。方法　应用骨髓短期培养法、染色体荧光原位杂交(FISH)技术及形态学技术 ,对 13例初治及 7例复发APL患者进行细胞遗传学和形态学分析。结果8例患者的骨髓APL细胞中均出现分化现象。 2 0例患者中 ,19例在TATS治疗过程中t(15 ;17)阳性细胞呈逐渐下降 ,与形态学APL细胞百分比的下降具有相关性 (r值范围 0 .72 98～ 0 .9989)。 19例具有t(15 ;17)染色体易位的患者治疗后均达血液学完全缓解 (CR) ,16例达细胞遗传学CR ,1例具有t(11;17)易位的患者未达血液学CR。结论　TATS对初治及复发APL有一定的诱导分化作用 ,单药TATS治疗初治及复发APL患者可达到血液学和细胞遗传学缓解。应用FISH技术监测t(15 ;17)阳性细胞可以客观反映APL细胞变化规律。Objective To study the morphologic and cytogenetic change in acute promyelocytic leukemia (APL) patients during the tetra arsenic tetra sulfide (TATS) treatment and the mechanism of TATS. Methods The bone marrow cells of 13 newly diagnosed and 7 recurrent APL patients were studied through FISH and morphology during the TATS treatment by special and repeated marrow culture. Results Cytomorphological study of 8 cases (6 untreated and 2 recurrent) showed that TATS could differentiate APL cells forward to mature granulocytes. There was obvious correlation between the reduced t (15;17) positive cells and the reduced APL cells ( r range 0.729 8 0.998 9 ). Except one patient with t (11;17), 19 (13 untreated and 7 recurrent) with translocation t (15;17) achieved clinical CR including 16 who achieved cytogenetic CR. Conclusion TATS has a differentiation inducing effect on untreated and recurrent APL, with haematological CR and cytogenetic CR achieved. Measurement of t(15;17) positive cells by FISH technique can reflect the change of APL cells objectively.

关 键 词：急性早幼粒细胞白血病 四硫化四砷 细胞形态学 细胞遗传学 作用机制 

分 类 号：R733.71[医药卫生—肿瘤]