摘要
目的 探索前瞻性诊断白血病前期 (白前 )的指标和方法。方法 采用同期病例对照研究 ,以慢性再生障碍性贫血 (CAA)和不发作型阵发性睡眠性血红蛋白尿症 (a PNH)为对照组 ,分析 2 1例白前患者临床和实验室特征及其与对照组间的差异。结果 白前与CAA、a PNH相比较 ,可以有以下特点 :①骨髓涂片可见或经微巨核酶标证实有淋巴样微巨核细胞 ;②外周血中出现幼稚粒细胞 ;③骨髓原始粒细胞≥ 0 .0 2 0 ;④骨髓有核红细胞糖原染色阳性 ;⑤髓系细胞分化指数 (DI)≥ 1.8;⑥有典型染色体核型异常 ;⑦姐妹染色单体分染阴性 ;⑧造血祖细胞体外培养粒 单核细胞集簇 /集落 >4.0。白前患者满足条件① ,并满足后 7项中任何 2项以上 (A)或满足 8项中任何 4项以上 (B) ;CAA和a PNH患者皆不满足A或B条件。结论 白前在骨髓细胞形态、组织化学染色、分化抗原表达、染色体核型、细胞分裂周期、造血祖细胞集落培养及临床治疗反应和预后方面与CAA和a PNH有明显差异 ,这些特点可能会有助于白前的前瞻性诊断。
Objective To explore prospective diagnostic criteria for preleukemia.Methods A case control study of the discrepancies of clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia(CAA) or atypical paroxysmal nocturnal hemoglubinuria(a PNH).Results There were eight variables of significance:①lymphocytoid micromegakaryocytes in marrow;②immature granulocytes in peripheral blood;③≥2% myeloblasts in marrow; ④positive periodic acid schiff (PAS) staining of nucleated erythrocytes;⑤myeloid differentiation index ≥1.8;⑥clonal karyotypic abnormalities; ⑦negative sister chromatid differentiation;⑧>4.0 cluster/colony ratio of granulocyte macrophage colony forming units(CFU GM). The following criteria was assigned: A:To meet ① and at least two of the other seven variables;B:To meet at least four of the eight variables.All of the patients with preleukemia met A or B and none of the patients with CAA or a PNH did.Conclusion Preleukemia is different from CAA or a PNH. It has its own clinical and laboratory features,which may be useful for prospective diagnosis.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2000年第4期182-186,共5页
Chinese Journal of Hematology
基金
卫生部临床学科重点项目!基金资助项目( 0 0 0 7)
中国医学科学院科学基金!资助项目 ( 95 2 0 40 )
关键词
白血病前期
临床研究
实验室诊断
Preleukemia
Clinical studies
Laboratories
Diagnosis
