49例急性白血病细胞遗传学分析

Cytogenetical analysis of 49 patients with acute leukemia

目的应用细胞遗传学分析方法研究急性白血病染色体异常特征,结合临床探讨细胞遗传学对急性白血病诊治的价值。方法采用短期培养法制备骨髓细胞染色体,以G显带对49例急性白血病患者进行染色体核型分析,并观察30例接受联合化疗患者的临床转归。结果49例初诊为急性白血病患者中,细胞核型异常检出率73%(36/49)。联合化疗30例中,首次住院达完全缓解者19例(63%)。核型正常及典型t(15;17)易位者疗效较好,核型异常如t(9;22)、t(5;17)等易位者疗效较差。结论半数以上急性白血病患者可检出克隆性染色体异常,其中,特异性染色体重排与特定的白血病亚型相关。细胞遗传学改变是影响白血病预后的因素。

Objective To analyze the karyotype of the patient with acute leukemia,and investigate the value of cytogenetic exam- ination in diagnosis and treatment of acute leukemia. Methods Cytogenetic examination of bone marrow cells was performed by short-turn culture method. G banding technique was used for karyotype analysis. 30 patients accepted combined chemotherapy. Their response and survival rate were analyzed. Results Cytogenetical abnormalities were found in 36 of 49 acute leukemia cases. The total rate of chromosomal abnormality was 73%. In all the 30 cases accepted chemotherapy, the complete remission rate was 63 % （19/30）. Patients with normal karyotype and typical t（15;17） showed a better response to chemotherapy than cases with aberrant karyotype such as t（9 ;22） and t（5 ; 17） etc. Conclusion Abnormal karyotype can be found in more than half of the acute leukemia cases. Some recurrent genetic abnormalities are usually associated with speeifical type of leukemia. Genetic abnormality is a factor influences the treatment response of acute leukemia.