慢性粒细胞白血病(儿童)128例染色体核型分析

Karyotype analysis of 128 cases of chronic myeloid leukemia(children)

目的分析慢性粒细胞白血病(儿童)128例染色体核型。方法选择2014年2月至2017年1月在该院接受治疗的慢性粒细胞白血病患者128例,患者骨髓及外周血液样本经培养后,采用R显带技术分析染色体核型。急变期积极治疗者随访6个月,以6个月内患者死亡或6个月为随访截止。结果128例慢性粒细胞白血病患者中包含pH阳性者115例(89.84%),pH染色体阴性者13例(10.16%);而pH阳性者中,变异型8例(6.96%),染色体核型演变者25例(21.74%),包括急变期20例(68.97%)、慢性期4例(4.17%)及加速期1例(33.33%);急变期29例中积极化疗者10例,完全缓解者4例,治疗无效者5例(均染色体复杂异常),治疗后6个月内死亡1例。结论分析慢性粒细胞白血病核型对判断白血病患者预后具有重要临床价值,附加染色体的复杂程度越高,提示该患者预后可能越差。

【Objective】To analyze 128 karyotypes of chronic myeloid leukemia(children).【Methods】A total of 128 patients with chronic myeloid leukemia who were treated in our hospital from February 2014 to January 2017 were selected.Chromosome karyotypes were analyzed by R-banding technique after bone marrow and peripheral blood samples were cultured.Patients who were actively treated during the blast phase were followed up for 6 months,and part of them died within 6 months.【Results】Of the 128 patients with chronic myeloid leukemia,115(89.84%)were pH-positive,13(10.16%)were pH-negative,and 8 cases(6.96%)were variants among pH-positive,25 cases(21.74%)were karyotype evolvers,including 68.97%(20/29)in the blast phase,4.17%(4/96)in the chronic phase,and 33.33%(1/3)in the accelerated phase;there were 10 patients treated with active chemotherapy,including 4 patients with completely remission,5 patients with ineffective treatment(all chromosome complex abnormalities),and 1 patient died within 6 months after treatment.【Conclusion】Analysis of chronic myeloid leukemia karyotype has important clinical value for judging the prognosis of leukemia patients.The higher the complexity of additional chromosomes,the worse the prognosis may be.