180例慢性粒细胞白血病骨髓染色体畸变及意义

Chromosomal abnormalities and clinical significance of bone marrow from 180 patients with CML

目的 研究骨髓染色体畸变与慢性粒细胞白血病 (慢粒 )不同病期的相关性及其临床意义。方法 采取新鲜骨髓 ,进行短期培养 (48小时或 12小时预加秋水仙素培养 )制备染色体标本 ,分析 180例慢粒患者慢性期、加速期、急变期骨髓染色体的变异情况。结果 180例慢粒患者 ,其中 16 4例Ph染色体阳性 (Ph +) ,占 91 1% ;16例Ph染色体阴性(Ph - ) ,占 8 9%。慢性期 133例Ph +,占总数的 73 9% ;加速期 9例Ph +,占总数 5 0 % ;急变期 2 2例Ph +,占总数12 2 %。 16 4例Ph +慢粒患者中 2 5例 (15 2 % )伴有额外染色体异常 ,其中慢性期占 4 2 7%、加速期占 2 4 %、急变期占8 5 3%。结果表明随着病情的进展 ,Ph +阳性率明显增高 ,其它染色体异常率也明显增高。结论 骨髓染色体畸变与慢粒白血病的病程进展、疾病预后有着十分重要的相关性 ,随着病情的演变 ,骨髓染色体畸变趋于复杂化。进行染色体分析对临床诊断及治疗慢粒具有十分重要的指导意义。

To investigate the correlation between chromosomal abnormalities and clinical phases of CML.Methods: Cytogenetic studies were performed according to conventional methods in bone marrow samples from 180 CML patients.Results: 180 patiens,in which 164 (91.1%)patients were Ph positive while 16(8.9%)patients were Ph negative,were investigated.The positivity of Ph chromosome in chronic phase(CP),accelerated phase (AP)and blast cell transformation phase(BP)was 73.9%(133/180),5%(9/180)and 12.2%(22/180),respectively.In the patients with Ph chromosome,there were 25(15.2%)patients with extra abnormal chromosomes.The extra chromosomal abnormality rate within patients with Ph chromosome was 4.3%,2.4% and 8.5% in CP,AP and BP,respectively.The results demonstrated that the Ph positivity and extra chromosomal abnormality were increased with the progression of CML.Conclusions: Chromosomal abnormalities were significantly correlated with the progression and prognosis of CML,and tented to be complicated with the progression of the disease,Therefore,cytogenetic analysis is of vital importance and instructive to the diagnosis and the rapy of CML.