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目的探讨伴有多系发育异常的急性髓细胞白血病(AML)的染色体特征及其临床疗效和预后判断价值。方法采用骨髓细胞短期培养法,应用G、R显带技术对28例伴多系发育异常的AML和179例不伴发育异常的AML进行染色体分析,统计染色体异常的患者1～4个疗程结束后治疗效果。结果伴有多系发育异常的AML患者染色体异常率为64.29%(18/28),主要的染色体异常为-5、del(5q)、-7、del(7q)、+8、+11、-Y、t(3;3)、t(6;9);无发育异常的AML患者染色体异常率为37.98%(68/179),23例有t(8;21)、t(15;17)、inv(16)等特征性染色体改变;染色体异常的患者经标准方案治疗后,伴有多系发育异常的AML患者缓解率(CR)低、缓解持续时间短,耐药发生率高。结论伴多系发育异常的AML有其独特的细胞遗传学特点,染色体异常的患者与不伴发育异常的AML相比显示预后不良。
Objective To investigate the chromosomal characteristics of acute myeloid leukemia (AML) with multi-line dysplasia and its clinical efficacy and prognostic value. Methods BMSCs were stained with G, R banding technique for 28 cases of AML with multiple lineage dysplasia and 179 cases of AML without dysplasia. One to four cycles of statistical analysis of chromosomal abnormalities were performed treatment effect. Results The chromosomal aberration rate of AML patients with multiple lineage dysplasia was 64.29% (18/28), the major chromosomal abnormalities were -5, del (5q), -7, del (7q), +8, +11, The chromosomal abnormalities in AML patients without dysplasia were 37.98% (68/179), 23 cases were t (8; 21), t (15; 17) , Inv (16) and other characteristic chromosome changes; patients with chromosomal abnormalities after treatment with standard regimen, with multiple lineage dysplasia of AML patients with low response rate (CR), short duration of response, the high incidence of drug resistance. Conclusion AML with multi-lineage dysplasia has its unique cytogenetic features. Patients with chromosomal abnormalities showed poor prognosis compared with non-dysplastic AML.