G显带核型分析与急性淋巴细胞白血病的预后

Prognostic significance of G-banded karyotype analysis in patients with acute lymphoblastic leukemia

目的探究染色体核型分析在急性淋巴细胞白血病(ALL)患者预后判断中的潜在应用价值。方法回顾分析2012年2月-2016年12月在温州医科大学附属第一医院新确诊的122例成人ALL患者的临床资料。应用染色体G显带技术进行核型分析。结果 122例ALL患者中共检出核型异常82例(67.2%),其中染色体结构异常中最常见为t(9;22),占26.2%。超二倍体组在所有组别中中位生存期最长;t(4;11)或亚二倍体组与正常核型和t(9;22)组相比较,总体生存率和无复发生存率均较低;正常核型和t(9;22)核型组预后中等,t(9;22)伴附加核型异常组预后较差。结论核型分析结果提示染色体异常与成人ALL预后相关,临床应根据不同染色体核型选择不同治疗方案。

Objective To explore the potentialities of applying chromosomal karyotype as a prognostic indicator in patients with acute lymphoblastic leukemia（ ALL）. Methods The clinical data of 122 newly diagnosed adults with ALL in the First Affiliated Hospital of Wenzhou Medical University during February 2012-December 2016 were retrospectively analyzed. Karyotype analysis was made for all cases using the G banding technique. Results Abnormal karyotype was identified in 82 patients（ 67. 2%）. The chromosome frequently involved in structural abnormalities was t（ 9; 22）,accounting for 26. 2%. Patients with hyperdiploid karyotypes had the best median overall survival. Patients with t（ 4; 11） or hypodiploidy all had inferior rates of overall survival and relapse free survival when compared with normal karyotype and t（ 9; 22） patients. Patients with normal karyotype and patients with t（ 9; 22） showed intermediate prognosis whereas patients with t（ 9; 22） and additional chromosome abnormalities showed poor prognosis. Conclusion Our karyotype analysis shows that chromosome abnormalities are relevant prognostic indicators in adult patients with acute lymphoblastic leukemia,and different treatment protocols should be chosen according to different karyotypes.