CAJ | 학술논문

目的探讨急性髓性白血病(AML)患者的细胞遗传学特征.方法采用骨髓短期培养和G显带技术对178例AML患者进行染色体核型分析.结果 178例患者中,171例有足够可供分析的中期分裂象.171例患者异常克隆检出率74.9%.其中27例患者为骨髓增生异常综合征(MDS)继发AML,其异常克隆榆出率为92.6%,在其余144例原发AML中异常克隆检出率为71.5%,MDS继发AML异常克隆检出率明显高于原发AML患者.171例患者中预后良好核型占24.0%,预后中等核型占46.8%,预后不良核型占29.2%.在预后良好核型中以t(15;17)为多;在预后中等核型中以正常核型为主;在预后不良核型中以复杂异常核型为主,复杂核型的异常克隆中常含有-5/5q-、-7/7q-等具有不良预后的异常克隆.老年组75例患者中,预后良好、预后中等及预后不良核型分别为16.0%、48.0%及36.O%,年轻组96例患者中分别为30.2%、45.8%及24.0%.老年患者预后良好核型比例低于年轻患者.MDS继发AML患者预后不良核型比例及单体核型比例均高于原发AML患者(P值均<0.001).结论 t(15;17)、正常核型、复杂核型分别是AML最常见的预后良好核型、预后巾等核型及预后不良核型.MDS继发的AML及老年AML患者染色体核型预后不良.
목적 탐토급성수성백혈병(AML)환자적세포유전학특정.방법 채용골수단기배양화G현대기술대178례AML환자진행염색체핵형분석.결과 178례환자중,171례유족구가공분석적중기분렬상.171례환자이상극륭검출솔74.9%.기중27례환자위골수증생이상종합정(MDS)계발AML,기이상극륭유출솔위92.6%,재기여144례원발AML중이상극륭검출솔위71.5%,MDS계발AML이상극륭검출솔명현고우원발AML환자.171례환자중예후량호핵형점24.0%,예후중등핵형점46.8%,예후불량핵형점29.2%.재예후량호핵형중이t(15;17)위다;재예후중등핵형중이정상핵형위주;재예후불량핵형중이복잡이상핵형위주,복잡핵형적이상극륭중상함유-5/5q-、-7/7q-등구유불량예후적이상극륭.노년조75례환자중,예후량호、예후중등급예후불량핵형분별위16.0%、48.0%급36.O%,년경조96례환자중분별위30.2%、45.8%급24.0%.노년환자예후량호핵형비례저우년경환자.MDS계발AML환자예후불량핵형비례급단체핵형비례균고우원발AML환자(P치균<0.001).결론 t(15;17)、정상핵형、복잡핵형분별시AML최상견적예후량호핵형、예후건등핵형급예후불량핵형.MDS계발적AML급노년AML환자염색체핵형예후불량.
Objective To explore the cytogenetic characteristics of acute myeloid leukemia(AML) patients.Methods The karyotype analysis was performed in 178 AML using the short-term culture of bone marrow cell and G-banding technique.Results Among the 178 patients,171 had enough metaphases for analysis and 128(74.9%)had clonal karyotypic abnormalities.Twenty-seven patients were secondary to myelodysplastic syndrome (MDS-AML),with 25 (92.6%) patients carrying clonal karyotypic abnormalities.Among the remaining 144 patients of de novo AML,103(71.5%)had clonal karyotypic abnormalities.The rate of abnormal clonal karyotype was higher in MDS-AML than that of de novo AML (P=0.021).Among the 171 patients,41(24.0%)were in favorable risk group,80(46.8%)in intermediate risk group and 50(29.2%)in adverse risk group.t(15;17)was the most common chromosomal aberration.The maiority intermediate risk chromosomal aberration was;normal karyotype.The most common cytogenetic abnormality among adverse group was a complex karyotype.Adverse cytogenetic aberrations,such as -5/5q-,-7/7q-,frequently occurred in conjunction with one another as part of a complex karyotype.Totally 75 patients were 60 years or older,among them,16.0%were in favorable risk group,48.0%in intermediate risk group and 36.0%in adverse risk group.Among 96 younger patients,30.2%were in favorable risk group.45.8%in intermediate risk group and 24.0%in adverse risk group.The rate of favorable risk chromosomal aberration was lower in elder patients than in younger(P=0.03 1).The rate of adverse risk chromosomal aberration and the rate of monosomal karyotype were higher in MDSAML than in de novo AML patients(P<0.001).Conclusions The most common favorable,intermediate and adverse chromosomal aberrations were t(15;17),normal karyotype and complex karyotype respectively.The karyotype was poor in MDS-AML and elder AML patients.