285例急性髓细胞白血病骨髓片三系增生异常的观察

Morphologic features of bone marrow smears of 285 patients with de novo acute myeloid leukemia (AML):studying trilineage myelodysplasia(TMDS)

伴有骨髓三系增生异常的初发急性髓细胞白血病是一种新认识的具有临床特色和难治性的ＡＭＬ亚型。回顾观察了１９９０年１月至１９９５年１２月初诊的２８５ＡＭＬ的骨髓涂片，发现ＴＭＯＳ（＋）ＡＭＬ４２例，占ＡＭＬ的１４．７％。与不伴有三系增生异常的ＡＭＬ相比，其贫血更严重，白细胞计数，外周血和骨髓中原始细胞百分比及治疗后完全缓解率均较低。

primary de novo acute myeloid leukemia with trilineage myelodysplasia(AML/TMDS)has been recently recognized as a new subtype of AML.Reviewed the bone marrow smears of 285 cases of primary de novo AML for investigating on TMDS,TMDS was identified in 42 cases(14 7%)and found in all FAB types(particularly in M 6)of AML,except in M 3. It was noted the remarkable clinical and hematological features of our group of 42 AML/TMDS patients,compared with those of AML without TMDS ones are more severe anemia,lower WBC,fewer median percentage of blasts in peripheral blood and in bune marrow,and lower rate of complete remission.