6例儿童急性淋巴细胞白血病染色体观察

PRELIMINARY OBSERVATION OF CHROMOSOMAL CHANGES OF SIX CHILDREN WITH ACUTE LYMPHOCYTIC LEUKEMIA

本文报告用骨髓细胞直接法常规制片,按丹佛(Denver)体系排列分析,对6例儿童急性淋巴细胞性白血病进行了染色体检查(1例于化疗前后、2例于复发时、3例于完全缓解期),共11例次核型分析。其中亚二倍体2例次,超二倍体5例次,二倍体2例次,未见分裂相2例次.有3例次见染色体结构异常。染色体变异似早于骨髓形态学变化,因此认为染色体变异有可能较早提示复发与预后的价值。

For more than one year,the authors had followed the chromosomal changes in 6 children with acute lymphocytic leukemia(ALL),5 males and 1 female,the ages rang-ing from 2-15 years.All were treated by using PV regimen for remission induction,6MP and MTX p.o.as maintenence therapy,periodical PV reinforcement,and prophylactic in-trathecal injection of MTX.Direct method was used to prepare bone marrow slides and the chromosomes were arranged into groups according to Denver system.The results of total 11 separate analyses of karyotypes were:hypodiploid 2 times,hyperdiploid 5 times,diploid 2 times and failure to find mitoses 2 times.Case 1 and 3 during relapse and case 2 when failed to respond to chemotherapy all presented aneuploid cells.Case 5 and 6 showed diploid cells during complete remission.Case 4 was in complete remission but had enlarged testes,and his general bone marrow picture was normal while hypodiploid cells were observed.This child relapsed within 6 months.These observations suggest that changes in chromosome precede changes in bone marrow picture,and may be used to predict prog-nosis or evaluate the efficacy of treatment.