119例慢性髓细胞白血病急变期核型分析

为了探讨慢性髓细胞白血病急变期（CML-BC）核型变化规律及意义，应用R显带技术对119例CML-BC患者的核型资料进行分析，并在其中随机选出28例以荧光原位杂交法（FlSH）检测衍生9号染色体[der（9）]是否缺失．结果表明：124例核型检查中Ph阴性11例（8．9％），P11阳性113例（91．1％），其中典型易位104例（83．9％），单纯变异易位4例（3．2％），复杂变异易位5例（4．0％）；Ph阴性CML-BC中72．6％伴有附加染色体异常，主要类型是：i（17q）、＋14，Ph阳性者72．3％伴有附加染色体异常，主要类型是：＋Ph、＋8、i（17q）；Ph阴性CML-BC急变时间为2-66月，平均29．0月，Ph阳性者急变时间为1-127月，平均34．2月，两组比较无统计学差异（P〉0．05）；FlSH检测发现5例（5／28，17．9％）der（9）缺失。结论：慢性髓细胞白血病急变期附加染色体异常多见，FlSH技术可有效检测der（9）缺失．

Karyotype Analysis in 119 Patients with Chronic Myeloid Leukemia at Blast Crisis

To investigate the karyotype of chronic myeloid leukemia in blast crisis (CML-BC), karyotype analysis was performed with R-banding technique in 119 patients with CML-BC. Dual fusion fluorescence in situ hybridization (FISH) was used to detect derivative chromosome 9 deletions in randomly selected 28 cases of them. The results showed that 11 cases (8.9% ) were Ph negative;113 cases (91.1% ) were Ph positive; 104 cases (83.9%) had standard Ph translocation;9 cases (7.2% ) showed variant translocation, including 4 cases (3.2%) with simple variant translocation and 5 cases (4.0% ) with complex variant translocation. 72.6% of Ph negative CML-BC had extra chromosomal abnormalities, with the most common ones being i(17q) and +14. 72.3% of Ph positive CML-BC had extra cytogenetic changes and +Ph, +8, i(17q) were the most frequent. The average time between diagnosis and blast crisis was 29.0 months (range 2 to 66 months) for Ph negative cases and 34.2 months (range 1 to 127 months) for Ph positive cases. 5 cases (5/28,17.9%) with der(9) deletions were detected by FISH technique. It is concluded that extra chromosomal abnormalities are common in CML-BC patients and FISH can effectively detect the der(9) deletions.