维甲酸治疗APL后骨髓组织的变化

Histopathological Findings of Bone Marrow in Acute Promyelocytic Leukemia after Retinoic Acid Treatment

目的探讨维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL)后骨髓组织形态学变化。 方法 30例APL病人的骨髓活检标本 ,分成治疗前、ATRA治疗后与化疗后三组 ,分别观察其骨髓造血功能与造血微环境的变化。结果APL经传统方法化疗后骨髓正常造血功能受到抑制 ,骨髓间质也受到很大的损害 ,表现为间质支架的塌陷 ,出血 ,骨髓坏死 ,结构脂肪的消失。APL经ATRA治疗后骨髓造血组织增生活跃 ,骨髓间质变化轻微。 结论ATRA治疗APL后并不抑制骨髓的造血功能 ,造血微环境保持良好 ,有利于治疗后正常造血功能的重建与修复。

Objective To study the histological changes in APL after ATRA treatment. Metho ds Bone marrow biopsy and histological studies were performed in 30 APL patients. Among them 10 cases were examined before treatment, 11 cases were treated by ATRA and 9 cases were treated by chemotherapy. Results Hypocellularity in bone marrow was observed after chemotherapy and the stroma was collapsed with edema and/or haemorrhage. The structural fat tissue disappeared. Bone marrow necrosis was seen in 6 cases. After ATRA treatmemt yet, the cellular elements accounted for 50%～60% of the contents. The stroma was slightly affected. Conclusion After ATRA treatmemt, normal haemopoiesis and suitable microenvironment maintained. It will be beneficial to subsequent regrowth of haemopoietic elements after treatment.