摘要:
Objective To report an acute promyelocytic leukaemia (APL) case with translocation of rob (13 ;21) t(15;17) (q22;q21) and review its clinical and laboratory characteristics.Methods Based on routine karyotype analysis and bone marrow morphology,we further used double color double fluorescent in situ hybridization (DCDF-FISH) and reverse transcriptase PCR (RT-PCR) to examine the patient' s abnormities on cytogenetic and molecular biology,and reveal the clinical characteristics of this rare translocation also from the related literatures.Results The clinical manifestation and bone marrow morphology examination of this patient were in accordance with pathologic feature of APL.On first visit,immunophenotyping analysis showed positive myeloid markers.Through R-banding,the patient' s karyotype was confirmed as 45,XX,rob (13;21) t (15;17) (q22;q21) [6] / 45,XX,rob (13;21) [14].FISH results showed that 68.9% cells were typical t (15;17) pattern.The positive rates of fusion gene of PML-RARα detected by RT-PCR was 25.8%.Patient was treated by induction and consolidation therapy,the karyotype was 45,XX,rob(13;21) [20] after complete remission.The positive rate of fusion gene of PML-RARα by FISH and its level were 2.5% and 0.003% respectively.Conclusion APL with rob (13;21) t (15; 17) (q22;q21) was very rare,which was accorded with clinical and laboratory characteristics of APL.The value of chromosome abnormality as a prognostic marker in APL needs to be further observed.%目的 报道1例初发伴有rob(13;21) t(15;17)(q22;q21)的急性早幼粒细胞白血病(APL)并探讨其临床和实验室特点.方法 在常规核型分析和骨髓细胞形态学的基础上,应用双色双融合荧光原位杂交(DCDF-FISH)和RT-PCR技术进一步检测该患者的细胞遗传学异常和分子生物学异常.并结合文献分析此类伴少见变异易位APL患者的临床特点.结果 患者的临床表现和骨髓细胞形态学检查均符合APL.初诊时免疫表型分析髓系标志呈阳性,R显带染色体分析显示患者核型为45,XX,rob(13;21)t(15; 17) (q22;q21) [6]/45,XX,rob(13;21)[14],FISH结果显示68.9%的细胞为典型的t(15;17)模式,RT-PCR结果显示PML-RARα融合基因水平为25.8%.经诱导化疗、巩固治疗后,达到完全缓解,核型为45,XX,rob(13;21) [20],FISH检测PML-RARα融合基因阳性细胞率为2.5%,PML-RARα融合基因水平为0.003%.结论 伴特征性的rob(13;21)t(15;17)(q22;q21)的APL十分罕见,患者临床表现和实验室检查基本符合APL的临床特点;该染色体异常对APL患者的预后判断价值仍需进一步的观察.