目的 分析研究老年急性髓细胞白血病(AML)染色体改变,评价细胞遗传学对老年AML预后的影响.方法 采用直接法和培养法制备骨髓细胞染色体,R显带,对34例老年AML患者进行染色体核型分析,观察治疗效果及预后.结果 34例中29例染色体检查成功,异常核型检出率58.6%(17/29),正常核型12例.29例AML患者接受正规治疗获完全缓解(CR)17例,部分缓解(PR)5例,未缓解(NR)7例.17例获CR的患者中5例t(15,17),7例正常核型,3例轻度核型异常,2例无分裂相;CR的患者中6例存活超过2年,其中3例t(15,17),2例正常核型,1例15p+.其余2例1个月内死亡,6例在1～2年内死亡,15例在1年内复发死亡.结论 老年AML有t(15,17)预后好,而其他核型预后差,大多1～2年内复发死亡.%Objective To analyze the chrumosome abnomalities in acute myeloid leukemia among the elderly,and to evaluate the valuc of cytogenetic analysis which can serve as an effective index for clinical prognosis in AmL among the elderly. Methods Cytogenetic analysis was performed in 34 paticnts with AML among the elderly. The chromosomes were prepared with direct method and brief culture of cells. The karyotype was detected by conventional cytogenetic R - banding. Clinical diagnosis and prognosis were observed. Results Cytogenetic analysis was performed succesifully in 29 patients. Chromosome abnomalities were identified in 58. 6％ of AML cases. Chemotherapy was given to 29 cases of AML, of whom , 17 cases achieved complete remission, five cases partial remission ,7 cases no remission. 5 cases had t(15.17) .7 cases had nomal chromosomes and 3 cases had mild abnomal chromosomes among 17 cases of AML which achieved complete remission. Three cases had t( 15, 17) ,2 cases had nomal chromnsomes. 1 case had 15p + in 6 cases who Iived more than 2 years. Two cases were dead in one month,6 cases in one to two vears and 15 cases in one year due to rclapsc. Conclution The patients with AML among the elderly with t( 15,17) had good prognosis, and the other types had poor prognosis and died in one to two vears due to relapse.
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