儿童急性淋巴细胞白血病细胞染色体核型检测与化学治疗疗效关系

目的探讨儿童急性淋巴细胞白血病（ALL）染色体核型检测与化学治疗疗效关系。方法采用G显带常规技术对ALL患儿的染色体核型进行分析。68例ALL患儿均给予长春新碱、吡柔比星、L-门冬酰胺酶和强的松联合化学治疗，按英国医学研究理事会标准，＋4、＋10、＋17、t（12；21）及正常核型为预后良好组，11q23、复杂核型及极差染色体未列出的其他异常核型为预后差组，t（9；22）及亚二倍体核型为预后极差组，观察各组完全缓解、部分缓解、未缓解及总有效率。结果预后良好核型组完全缓解率明显优于核型差及极差组（Х^2=21．887，P〈0．001），总有效率差异也有统计学意义（Х^2=19．737，P〈0．001）.结论染色体核型检测对ALL患儿化学治疗疗效及预后判断有指导意义，预后差组不应选用常规方案诱导治疗，而应选用疗效更好的方案。

Relationship of children acute lymphoblastic leukemia karyotype detected with chemotherapeutic effect

Objective To explore the relationship of detected children acute lymphoblastic leukemia karyotype with chemotherapeutic effect. Methods Conventional cytogenetic technique of G-band was used to analyze 68 children acute lymphoblastic leukemia patients. According to UK Medical Research Council＇s criteria, ＋4, ＋10, ＋17, t（12; 21） and normal karyotype were the favorable group; 11q23, complicated karyotype and the other adverse karyotype group were adverse group; t（9; 22） and hypodiploid were the terribly adverse group. They were treated with vincristine, pirarubicin, L-asparaginase, prednisone respectively. Then complete remission, partial remission and non-remission and total effective rate were observed. Results There were statistical significances between the complete remission rate （Х^2=21.887, P 〈0.001） and total effective rate （Х^2=19.737, P 〈0.001） of three groups. Conclusion Karyotype detection is an important chemotherapeutic and prognostic factor to children acute lymphoblastic leukemia. Conventional chemotherapeutic schema should not be used in adverse group and better schema should be used.