伴特异性染色体髓细胞白血病患者细胞形态学特征与临床表现

Hematological and clinical features of patients with myeloid leukemia with specific chromosome

目的:分析206例初发髓细胞白血病,急性原始粒细胞白血病部分分化型(M2b)、急性早幼粒细胞白血病(M3)、急性粒鄄单核细胞白血病伴嗜酸性粒细胞增多亚型(M4EO)和慢性粒细胞性白血病(CML)患者细胞形态学特征及临床表现。方法:采用细胞形态学(M)结合细胞遗传学(C)和分子生物学(M)检查方法检测患者骨髓标本。结果:细胞形态学特征:M2b为异常中幼粒细胞增生,M3为异常早幼粒细胞增生,M4EO为异常嗜酸性粒细胞增生,CML为粒系细胞增生。染色体及融合基因检测表明:M2b、M3、M4EO、CML分别与各自特异性染色体及融合基因t(8;21)(q22;q22)/AML1鄄ETO、t(15;17)(q22;q21)/PML鄄RARα、inv(16)(p13;q22)/CBFβ鄄MYH11、t(9;22)(q34;q11)/BCR鄄ABL密切相关。结论:①M2b、M3、M4EO、CML4种白血病患者不论在临床特点上,还是细胞形态学上都有各自一定的特征。②4种白血病分别与特定的染色体及融合基因具有一定的相关性。③特定的染色体和融合基因可作为白血病的标记物,对白血病的诊断、预后估计、监测治疗和微小残留白血病等都具有一定价值。

Objective To analyze t he hematological and clinical features of206patients with4subtypes myeloid leukemi a(M 2 b,M 3 ,M 4 E O and CML).Methods Specimens of bone marrow of the patients were analyzed by c ytomorpholo-gy,cytogenetics and molecular biology.Results The cytomorphological features of bone marrow showed abnormal neurtrophilic myelocyte in patients wit h M 2 b;abnormal promyelocyte in M 3 ;abnormal eosinophilic granulocyte in M 4 E O and myelocyte in CML.M 2 b,M 3 ,M 4 E O and CML were closely related to their specific chromosome and fusion gene t( 8;21)(q22;q22)/AML1-ETO,t(15;17)(q22;q21)/PML-RARá,inv(16)(p13;q22)/CBFa-MY H11and t(9;22)(q34;q11)/BCR-ABL.Conclusion M 2 b,M 3 ,M 4 E O or CML each has its main special clinical features and cytomorphological,cyt ogenetical and molecular biological parameters,and closely related to its specif ic chromosomes and fusion gene.The specific chromosome and fusion gene are regar ded as a marker of the diagnosis,prognosis,treatment and surveillance in patient s with leukemia.