慢性髓性白血病急性变时染色体变化的研究

目的：探讨慢性髓性白血病（ＣＭＬ）急性变时染色体的变化及与预后的关系。方法：取２０例（ＣＭＬ病人急性变前、后外周血或骨髓液、处理后制片，Ｇｉｅｍｓａ染色，Ｇ显带或Ｒ显带，在显微镜下摄影后配对、分析。结果急性变前ｐｈ染色体阳性１８例，阴性２例。急性变后１９例附加出现了新的染色体异常。染色体数目异常超二倍体占１５／２０。附加出现的异常染色体中，＋８、＋１９、＋２２ｑ－及Ｉ（１７ｑ）中的我个或多个异常蝇

Study of Chromosome Change in Chronic Myelogenous Leukemia in Blastic Crisis

Objective: This study was to explore the relationship between prognosis and chromosome changes in chronic myelogenous leukemia (CML) in blastic crisis. Methods: The blood or marrow samples of 20 CML patients were smeared before blastic crisis and during blastic crisis, and stained with Giemsa, G banding or R banding. The praparations were pairde and the data were analyzed after taking a photograph under the microscope. Results: Before blastic crisis, Philadelphia chromosome (ph) were positive in 18 cases, and negative in 2 patients. Other chromosomal abnormalities were superimposed in 19 patients except one case in blastic crisis. Hyperdiploid occurred in 15 cases. And 13 patients showed one or more of the additional chromosome abnormalities: a 8, a 19, a 22q-or an i(17 q). Additional chromosome abnormalities appeared in 4 patients prior to the development of blastic crisis in clinical and hematologic examination. All of patients were dead except that 2 were beyond supervision. The median survival after blastic crisis was only 2.2 months. Conclusion: In the chronic phase of CML (before blastic crisis), chromosomal abnormalities besides ph indicate an unfavorable prognosis. It hints poorer prognosis when the patients have hyperdiploid abnormality and have chromosome karyotype abnormalities as 8, 19 and 22q- at the same time in a non random pattern.