急性单核细胞白血病M_(5a)和M_(5b)细胞遗传学与临床表现的比较(英文)

Comparison of Cytogenetics and Clinical Manifestations between M_(5a) and M_(5b) of Acute Monocytic Leukemia

为了比较急性单核细胞白血病M_(5a)和M_(5b)细胞遗传学差异,并研究其与临床行为之间的相互关系,采用骨髓直接法和24小时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白血病细胞进行核型分析,同时对其临床资料进行回顾性研究。结果表明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=0.0001),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(WBC)计数,中枢神经系统浸润,完全缓解(CR)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似乎具有各自独特的遗传学背景和临床表现。

To compare the cytogenetic difference between M5a and M5b of acute monocytic leukemia and to study the correlation between karyotypes and clinical manifestations, a total of 58 cases of de novo adult AML M5 have been investigated. Chromosome metaphases of bone marrow cells were prepared by using direct method and 24 hours short-term culture. The karyotypes were analyzed by G-banding. Meanwhile, clinical information of these cases were studied retro- spectively. The results showed that there were 28 with normal karyotype and 30 with aberrant karyotype in 58 cases. The frequency of normal karyotype in patients with M5b was significantly higher than that in patients with M5a （P = 0. 0001 ）. The 11 q23 aberrations and trisomy 8 were more common in patients with M5a in comparison with patients with M5b （ P 〈 0.01 ）. The patients with AML M5 with aberrant karyotype had a higher incidence of hyperleucocytosis, extramedullary central nerve system infiltration, lower complete remission （CR） rate and shorter overall survival, It is concluded that acute monocytic leukemia is a series of heterogeneous diseases, a distinctive cytogenetic features can be observed between patients with AML M5a and M5b, these results will provide insights into the classification and pathogenesis mechanism of AML M5 at molecular level.