染色体核型与急性髓系白血病诱导成功的关系

Relationship between Chromosome Karyotype and Induction Success in Acute Myeloid Leukemia

目的评价染色体核型在急性髓系白血病(AML)WHO分型系统中的作用。方法 107例AML患者按WHO标准进行分型诊断,并对诊断后各亚型之间的诱导化疗完全缓解率(CR)进行分析。结果 AML中伴有重现染色体异常36例(33.6%),染色体核型均为低危;伴有多系发育异常24例(22.4%),染色体核型中危17例、高危7例;不另做分类占47例(43.0%),染色体核型中危39例、高危8例。伴(t8;21)和伴inv(16)或(t16;16)患者的诱导化疗CR率显著高于不另做分类的(P<0.05)。有多系增生异常患者的诱导化疗CR率明显低于无多系增生异常患者(P<0.05)。结论 AML各亚型之间诱导化疗CR率不同,细胞遗传学是预测急性髓系白血病达到CR最有用的因子之一。

Objective To explore the role of chromosome karyotype in the WHO classification of acute myeloid leukemia（AML）. Methods One hundred and seven patients were diagnosed as AML according to the WHO classification. A comparative analysis was made of the complete remission rate（CR） of preoperative induction chemotherapy between the various subtypes. Results In 107 cases of AML, 36 cases（33.6%） showed the recurrent chromosome abnormalities and chromosome karyotype was of favorable risk, 24 cases（22.4%） showed muhilineage dysplasia, 17 cases were of intermediate risk and 7 cases were of high risk. And other 47 cases （43.0%） failed to be categorized,in which 39 cases were of intermediate risk and 8 cases were of high risk. The CR rate of induction chemotherapy in the AML cases with t（8;21 ）and AML with inv（ 16）or t（ 16; 16）was significantly higher than that of those eases that failed to be categorized（P〈0.05）. The CR rate of inductien chemotherapy in the AML cases with multilineage dysplasia was significantly lower than that of the AML cases without muhilineage dysplasia（P〈0.05）. Conclusion The CR rates of induction chemotherapy are different between the various subtypes of AML, and cell genetics is one of the most useful factors for predicting the attainment of CR in AML.