225例急性髓细胞白血病的细胞遗传学研究

A Cytogentic Analysis on 225 Cases of Acute Myel Ogenous Leukemia

目的 探讨急性髓细胞白血病 (AML)的细胞遗传学改变及与诊断、治疗、预后的关系。方法 对 2 2 5例初治AML的患者进行骨髓染色体分析 ,采用短期培养法制备骨髓细胞染色体G显带。结果 发现本组 131例 ( 5 8.2 % )有克隆性染色体异常。共有 14种核型异常。t( 15 ;17)、t( 8;2 1)、t( 9;2 2 )为最常见的结构异常 ,且t( 15 ;17)、t( 8;2 1)、inv( 16 )分别仅见于M3 、M2 、M4E0 。核型异常与临床完全缓解率 ,完全缓解持续时间及中位生存期等预后高度相关 ,t( 15 ;17)、t( 8;2 1)完全缓解率高 ,完全缓解期及中位生存期长 ,预后相对较好。而正常核型次之 ,其它核型异常预后较差。结论 染色体研究对AML的诊断 ,分型 ,治疗选择及预后估计均有重要意义。

Objective To evaluate cellular genetic changes and values in diagnosis,treatment and prognosis of acute myelogenous leukemia (AML).Methods A total of 25 cases of de novo AML were studied.Chromosome preparation was made of bone marrow cells using short term culture.Karyotypes were analyzed by G banding in all cases.Rusults One hundred and thirty one cases(58.2%)had clonal chromosomal abnormalities.Forteen categories of karyotypic abnormalities were found.t(15;17)?t(8;21)?t(9;22)were the most frequent structural abnormalities.t(15;17) ?t(8;21)?inv(16) were indicated in patients with M 3?M 2?M 4E 0.Chromosome abnormalities were associated with complete remission(CR)rate,CR duration and median survival time.Patients with t(15;17)?t(8;21) had a significantly higher indidence of CR rate,longer CR duration and longer survival time.The normal karyotype had the intermediate prognosis and other chromosome translocations the poorest prognosis.Conclusion Chromosome Karyotype is important in diagnosis classify choice of treatment and assess of prognosis of AML.