CAJ | 학술논문

目的：探讨慢性淋巴细胞白血病患者骨髓中幼稚淋巴细胞比例与疾病预后的关系。方法：收集西安交通大学医学院第一附属医院血液内科2012年6月至2015年5月收治的32例慢性淋巴细胞白血病患者的临床资料，其中骨髓涂片幼稚淋巴细胞≥5％的患者18例（A 组），骨髓涂片幼稚淋巴细胞＜5％的患者14例（B 组），观察两组患者骨髓形态学、免疫分型、FISH 检测结果及总生存率的差异。结果：A 组患者 CD38及FMC -7表达者较 B 组患者多见，FISH 检测结果提示 p53、ATM 及+12预后不良指标在 A 组患者中更易见。A 组慢性淋巴细胞白血病患者1年、3年及5年总生存率分别为93.3％、83.3％和59.3％，B 组慢性淋巴细胞白血病患者均存活超过5年。结论：慢性淋巴细胞白血病患者骨髓涂片中幼稚淋巴细胞≥5％的患者预后较幼稚淋巴细胞＜5％的患者差，骨髓幼稚淋巴细胞比例有可能作为初步预测预后的指标之一。
목적：탐토만성림파세포백혈병환자골수중유치림파세포비례여질병예후적관계。방법：수집서안교통대학의학원제일부속의원혈액내과2012년6월지2015년5월수치적32례만성림파세포백혈병환자적림상자료，기중골수도편유치림파세포≥5％적환자18례（A 조），골수도편유치림파세포＜5％적환자14례（B 조），관찰량조환자골수형태학、면역분형、FISH 검측결과급총생존솔적차이。결과：A 조환자 CD38급FMC -7표체자교 B 조환자다견，FISH 검측결과제시 p53、ATM 급+12예후불량지표재 A 조환자중경역견。A 조만성림파세포백혈병환자1년、3년급5년총생존솔분별위93.3％、83.3％화59.3％，B 조만성림파세포백혈병환자균존활초과5년。결론：만성림파세포백혈병환자골수도편중유치림파세포≥5％적환자예후교유치림파세포＜5％적환자차，골수유치림파세포비례유가능작위초보예측예후적지표지일。
Objective:To observe the relationship between the percentage of prolymphocyic cells in bone marrow and the prognosis of chronic lymphocytic leukemia patients. Methods:Clinical data of thirty two chronic lymphocytic leukemia patients who were received in the Department of Hematology,the First Affiliated Hospital of Xiˊan Jiaotong University from June 2012 to May 2015 were retrospectively analyzed. Patients were divided into two groups:18 pa-tients with percentage of prolymphocytic cells in bone marrow more than 5%(group A),14 cases of patients with per-centage of prolymphocytic cells in bone marrow smear less than 5%(group B). Bone marrow morphology,immune typ-ing,FISH detection and the overall survival rates between two groups were observed. Results:Patients with CD38 or FMC - 7 expression were more easily seen in patients of group A. p53 deletion,ATM deletion and + 12 were more easily seen in patients of group A. The overall survival rates of one,three and five years in patients of group A were 93. 3% ,83. 3% and 59. 3% ,respectively. Patients in group B were all alive for more than 5 years. Conclusion:The prognosis of chronic lymphocytic leukemia patients with percentage of prolymphocytic cells in bone marrow more than 5% was poor compared with patients with percentage of prolymphocytic cells in bone marrow less than 5% . Prolym-phocytic cells in bone marrow may be an index of prognosis.