摘要
目的 探讨急性髓性白血病（AML）患者的细胞遗传学特征.方法 采用骨髓短期培养和G显带技术对178例AML患者进行染色体核型分析.结果 178例患者中,171例有足够可供分析的中期分裂象.171例患者异常克隆检出率74.9%.其中27例患者为骨髓增生异常综合征（MDS）继发AML,其异常克隆榆出率为92.6%,在其余144例原发AML中异常克隆检出率为71.5%,MDS继发AML异常克隆检出率明显高于原发AML患者.171例患者中预后良好核型占24.0%,预后中等核型占46.8%,预后不良核型占29.2%.在预后良好核型中以t（15;17）为多;在预后中等核型中以正常核型为主;在预后不良核型中以复杂异常核型为主,复杂核型的异常克隆中常含有-5/5q-、-7/7q-等具有不良预后的异常克隆.老年组75例患者中,预后良好、预后中等及预后不良核型分别为16.0%、48.0%及36.O%,年轻组96例患者中分别为30.2%、45.8%及24.0%.老年患者预后良好核型比例低于年轻患者.MDS继发AML患者预后不良核型比例及单体核型比例均高于原发AML患者（P值均〈0.001）.结论 t（15;17）、正常核型、复杂核型分别是AML最常见的预后良好核型、预后巾等核型及预后不良核型.MDS继发的AML及老年AML患者染色体核型预后不良.
Objective To explore the cytogenetic characteristics of acute myeloid leukemia（AML） patients.Methods The karyotype analysis was performed in 178 AML using the short-term culture of bone marrow cell and G-banding technique.Results Among the 178 patients,171 had enough metaphases for analysis and 128（74.9%）had clonal karyotypic abnormalities.Twenty-seven patients were secondary to myelodysplastic syndrome （MDS-AML）,with 25 （92.6%） patients carrying clonal karyotypic abnormalities.Among the remaining 144 patients of de novo AML,103（71.5%）had clonal karyotypic abnormalities.The rate of abnormal clonal karyotype was higher in MDS-AML than that of de novo AML （P=0.021）.Among the 171 patients,41（24.0%）were in favorable risk group,80（46.8%）in intermediate risk group and 50（29.2%）in adverse risk group.t（15;17）was the most common chromosomal aberration.The maiority intermediate risk chromosomal aberration was;normal karyotype.The most common cytogenetic abnormality among adverse group was a complex karyotype.Adverse cytogenetic aberrations,such as -5/5q-,-7/7q-,frequently occurred in conjunction with one another as part of a complex karyotype.Totally 75 patients were 60 years or older,among them,16.0%were in favorable risk group,48.0%in intermediate risk group and 36.0%in adverse risk group.Among 96 younger patients,30.2%were in favorable risk group.45.8%in intermediate risk group and 24.0%in adverse risk group.The rate of favorable risk chromosomal aberration was lower in elder patients than in younger（P=0.03 1）.The rate of adverse risk chromosomal aberration and the rate of monosomal karyotype were higher in MDSAML than in de novo AML patients（P〈0.001）.Conclusions The most common favorable,intermediate and adverse chromosomal aberrations were t（15;17）,normal karyotype and complex karyotype respectively.The karyotype was poor in MDS-AML and elder AML patients.
出处
《中华内科杂志》
CAS
CSCD
北大核心
2011年第8期683-686,共4页
Chinese Journal of Internal Medicine
