骨髓增生异常综合征RAEB、RAEB-T和老年急性髓系白血病的临床对照分析

A comparative study of MDS-RAEB,MDS-RAEBT and AML in the elderly

目的：在WHO分类中，FAB分型中的骨髓增生异常综合征一难治性贫血伴原始细胞增多转化型（MDS—RAEBT）被划分为急性髓系白血病（AML），本文探讨该划分的合理性。方法：采用病例对照研究比较58例老年AML患者、88例骨髓增生异常综合征-难治性贫血伴原始细胞增多（MDS-RAEB）10％～19％（骨髓原始细胞10％～19％）患者和37例MDS-RAEBT患者在临床和染色体核型及共同累及的染色体异常类型上的区别。结果：MDS-RAEBT和MDS-RAEB在病程、WBC、Hb、肝脾肿大比例、正常核型和复杂核型比例及共同累及的染色体异常类型上差异无统计学意义，而和老年AMI，患者比较差异有统计学意义。结论：MDS-RAEBT应该划分为MDS，该结论有待于前瞻性实验进一步验证。

Objective：To investigate whether MDS-RAEBT of FAB subtype should be classified into AML according to WHO criteria. Method：We studied a cohort of 183 patients, 37 with MDS-RAEBT and 88 with MDS- RAEB10%-19% （RAEB with 10%-19% blast cells）and 58 with elderly AML, and compared clinical and cytogenetic characteristics of the three groups. Result： MDS-RAEBT patients bore more resemblance to MDS-RAEB10%-19% than to patients with AML in the elderly in the clinical features, in the frequency of hepatosplenomegaly and karyotypes and in the number of shared chromosomal aberration, but there were no significant differences between three groups in cytogenetic features. Conclusion： MDS-RAEBT should be classified into MDS. This conclusion is worth further investigation by prospective study.