急性早幼粒细胞白血病患者的染色体异常与临床

The chromosomal abnormality and clinical picture in acute promyelocytic leukemia patients

目的 :探讨急性早幼粒细胞白血病 (APL)患者染色体异常与临床特点间的关系 ;方法 :对 2 2例APL患者进行染色体核型分析 ,将其分为t(1 5 ;1 7)阳性组与阴性组 ,并比较其临床特点 ;结果 :6例t(1 5 ;1 7)阴性的APL患者中有 5例在临床特点及全反式维甲酸 (ATPA)治疗效果上与t(1 5 ;1 7)阳性组相比无明显差异 ,但另一例t(1 5 ;1 7)阴性者用ATRA治疗一直未达完全缓解 (CR)。 1 6例t(1 5 ;1 7)阳性者在达CR后仍有 1 0例 (占 6 2 % )可查到t(1 5 ;1 7)存在 ;结论 :在ATRA诱导达CR后应及时、充分地巩固强化治疗 ,对t(1 5 ;1 7)阴性者应进行PML—RARα 融合基因的检测 ,根据基因检测结果决定治疗方案。

Objective:To investigate the relation between the chromosomal abnormality and the clinical picture in acute promylocytic leukemia(APL).Methods:chromosomal karyotype have been studied in 22 APL patients.They were divided into t(15;17)-positive group and t(15;17)-Negative group.We compared the clinical picture of the two groups.Results:The clinical picture and therapeutic effect of All-trans retinoic acid(ATRA) treatment in five of the six patients without the 15;17 chromosomal translocation did not differ from that in the patients with the 15;17 chromosomal translocation.But another patient without t(15;17) chromosomal abnormality did not achieve complete remission(CR).Conclusion:The patients should be further treated in time and thoroughly by intensive chemotheratpy after they achieved CR induced by ATRA.The detection of PML-RAR α fusion gene should be performed on the APL patients who lacked the 15;17 chromosomal translocation and the treatment plan should be determined by the result of the gene detection. [