急性单核细胞白血病M_(5a)和M_(5b)核型与临床特征的比较

Comparison of karyotypes and clinical characteristics between M_(5a) and M_ (5b)of acute monocytic leukemia

目的:比较急性单核细胞白血病M5a和M5b核型差异,并了解其与临床特征之间的相互关系。方法:采用骨髓直接法和24h短期培养法制备染色体标本,用G显带技术,对58例成人初发急性单核细胞白血病进行核型分析,同时对其临床资料进行回顾性研究。结果:58例患者中正常核型28例,异常核型30例,其中,正常核型在M5b中出现率高于M5a(P<0.01),异常核型中11q23异常和+8染色体在M5a中均较M5b常见(P<0.01);临床上异常核型的M5患者常有高白细胞计数,中枢神经系统浸润,完全缓解率低及存活期明显缩短的特征。结论:急性单核细胞白血病在遗传和临床上是一组异质性疾病,但M5a和M5b仍具有各自独特的遗传学背景。

Objective:To compare the cytogenetic difference between M_ 5a and M_ 5b of acute monocytic leukemia and explore the relationship between subtypes and clinical characteristics.Method:A total of 58 cases of de novo adult AML M_5 was studied. Chromosome preparations of bone marrow cells were made by using direct method and 24 hours short-term culture. Karyotypes were analyzed by G-banding. Meanwhile, clinical features of these cases was studied retrospectively.Result:There were 28 patients with normal karyotype and 30 cases with aberrant karyotype. The frequency of normal karyotype in M_ 5b was higher than that in M_ 5a (P< 0.01). The 11q23 aberrations and trisomy 8 were common in M_ 5a in comparison with M_ 5b (P< 0.01). AML M_5 patients with aberrant karyotype were hyperleucocytosis, extramedullary disease with central nerve system infiltration, lower complete response (CR) rate and short survival.Conclusion:Acute monocytic leukemia is a series of heterogeneous disease, AML M_5a and M_5b has its own cytogenetic features.