摘要
本组用G显带法对42例急性非淋白血病(ANLL)核型进行研究。FAB分类:M_228例、M_311例、M_1、M_4、M_6各1例。正常核型16例,占38.1%,异常核型26例,占61.9%,其中t(8:21)7例,占总数16.7%,占M_2的25%;t(15:17)7例,亦占总数16.7%,占M_3的64%;乃外还发现少见核型t(7:11)2例,ph(+)2例,3q21断裂2例,各占4.7%;—y6例,其中4例与t(8:21)同时存在。t(8:21)7例中4例有—y;超二倍体7例,多于亚二倍体,以+8+13多见,伴有t(8:21)、t(15:17)各1例。42例中35例经维甲酸(RA)诱导分化(M_3)或化疗(DA,HAT,HOAP)(其它FAB类型),16例完全缓解,总缓解率为45.7%,中位生存期在缓解病例为9^+月,未缓解病例为3月(P<0.01)。所有缓解病例的核型都在正常核型、t(8:21)、t(15:17)、t(7:11)和—y范围内,而超二倍体、ph(+)及3q21断裂核型中无1例达到完全缓解。本组研究除发现数例罕见核型外,显示ANLL核型检查对予后判断有明显价值。
Chromosomal anaiysis with G—Banding technique was performed in Forty—Two patients with acute non—lymphocytic leukemia(ANLL).Normal karyotype occurred in 16 cases(38.1%).Abnormal karyotypes were found in 26 cases(61.9%),some have not been reported in Chinese literature,t(7;ll)(P15;P15)in two cases,Ph^+ in two cases,3q21 breakage in two cases,and t(8;21)and t(15; 17)in seven cases(16.7%)respectively.Loss of Y chromosome was seen in 6 cases,including 4 of 5 male cases with t(8;21).Hyperdiploidy occurred in 7 cases,35 cases were treated and 16 cases achieved complete remission.Median survival time was 9^+ months in responders and 3^+ months in non—responders(p<0.01).The karyotype in all the responders were normal or limited to t(8:21),t(15:17),t(7:ll).Loss of Y chromosome had no effect on remission rate.None of the patient with karyotype such as hyperdiploidy.ph^+ and 3q21 breakage,responded to induction therapy.The results suggest that chromosome analysis is a useful method to evaluate the prognosis of ANLL.
