成人急性白血病患者染色体核型的临床分析

摘要

目的 探讨成人急性白血病(AL)患者染色体核型及各亚型核型变化的特征.方法 应用R显带染色体分析技术,对初诊的285例成人AL患者进行骨髓或外周血染色体检查,分析染色体异常与白血病类型的关系.结果 AL患者平均异常染色体检出率为56.4％,其中急性髓系白血病(AML)和急性淋巴细胞白血病(AL)分别为55.6％(123/221)、58.8％ (30/51),骨髓异常综合征转化为AML者为57.1％ (4/7),淋巴肉瘤白血病为66.7％.(4/6).异常染色体中,M3染色体变化较一致,以t(15;17) (q22;q11)改变为主；ALL患者异常检出率最高的是t(9；22),其他类型白血病染色体异常存在不一致性.AML和ALL染色体核型预后良好组、预后不良组和中间组的白血病缓解率差异有统计学意义(P＜0.01).结论 染色体核型分析对AL的分型诊断、治疗和预后判断具有重要参考价值.%Objective To investigate the characteristics of chromosome abnormalities in adult acute leukemia (AL) patients and the distribution of subtypes of karyotype changes.Methods All the 285 cases of adult patients with AL received bone marrow or peripheral blood chromosome detection to analyze the relationship between chromosome abnormality and leukemia type by using R banding conventional chromosome analysis technology.Results The abnormal chromosome detection rate of AL adult patients was 56.4％ in average.The rates of chromosomal abnormalities in patients with acute leukemia karyotype in acute myelocytic leukemia (AML) and acute lymphocytic leukemia (ALL) were 55.6 ％ (123/ 221) and 58.8％ (30/51) respectively.The rate of chromosomal abnormalities from MDS into AML was 57.7％ (4/7),and into lymphosarcoma leukemia was 66.7％ (4/6).In the chromosomal abnormalities,M3 was more consistent in chromosomal change,accounting for t(15;17) (q22;q11) changes in the main; t (9 ;22) was the most common change in ALL patients; while the other types of leukemia chromosome abnormality was not consistent.Both AML and ALL groups,the difference rate in poor prognosis group,intermediate group and good prognosis of leukemia remission was statistically significant (P ＜ 0.01).Conclusion Karyotype analysis is helpful for the diagnosis,treatment and prognosis of leukemia.