急性粒-单核细胞白血病及急性单核细胞白血病MLL基因重排的检测

Detecion of MLL gene rearrangement in acute myelomonocytic and monocytic leukemia

了解ＭＬＬ基因重排在急性粒－单核细胞白血病（Ｍ４）及急性单核细胞白血病（Ｍ５）中的发生率及其特点。方法用Ｓｏｕｔｈｅｒｎ印迹法对１０例Ｍ４及２７例Ｍ５患者进行ＭＬＬ基因重排的检测。结果共发现５例Ｍ５患者伴有ＭＬＬ基因异常，此组患者发病年龄轻，发病时白细胞数高，肝脾肿大明显，易并发中枢神经系统白血病，完全缓解率低，平均生存期短。结论ＭＬＬ基因重排在Ｍ５中发生率高，且此基因异常是预后不佳的标志。

Objective To reveal the incidence of MLL gene rearrangement and its clinical,fea-tues in acute myelomonocytic leukemia (M 4) and acute monocytic leukemia (M 5).Methods 10 pa-tients with M 4 and 27 cases with M 5 were studied with the Southern blot technipue to detect MLL gene abnormalities.Results5 M 5 patients were found to have MLL rearrangement,and these pa-tients were characterized clinicaly by:(1) Younger at onset,(2) a higher white blood cell count (of-ten>100×10 9/L),(3) frepuent extramedullary involvement with hepatosplenomegaly and central nervous system leukemia (SNSL),and (4) a lower remission rate with a short survival time.Con-clusion There is a high incidence of MLL rearrangement in M 5,and this gene abnormality stands for a marker of poor prognosis