急性髓细胞白血病M2亚型细胞形态学及细胞遗传学分析

目的:了解急性粒细胞白血病AML-M2亚型的细胞形态学及细胞遗传学特征.方法:对23例以FAB分类标准确诊的AML-M2初发患者的细胞形态学及细胞遗传学资料进行回顾性分析;应用骨髓细胞短期培养法制备染色体标本,以R显带技术进行核型分析.结果:34%M2a、92%M2b患者白血病细胞内可见Auer小体,Auer小体在M2b患者细胞中检出率明显高于M2a患者;M2患者白血病细胞POX染色呈强阳性反应,在M2a细胞表达多为弥散细颗粒状,而在M2b呈局灶团块状.23例患者中18例有克隆性染色体异常,异常核型检出率78.3%(18/23).16例M2a患者无一致性的染色体异常.7例M2b患者均有特异性的t(8;21)异常,其中3例伴有y染色体丢失.结论:M2白血病组内异质性较大,M2a和M2b似乎具有各自独特的细胞形态学及细胞遗传学特性.

Morphologic and Cytogenetic Analysis of 23 Cases in M2 Subtybe of Acute Myeloid Leukemia

Objective: To investigation the Morphologic and Cytogenetic characteristics of the M2 subtybe of acute myeloid leukemia.Method: A retrospective study of 23 AML-M2 defined following the FAB classification was performed;Chromosome specimens were prepared by short-term culture of bone marrow cells and karyotype analyses were carried out using R-banding techniques.Result: Auer rods can be discovered in patients with M2a and M2b(34% and 92%,respectively).The frequency of auer rods in patients with M2b was significantly higher than that in patients with M2a(P<0.01).The scattergram of myeloperoxidase-positive reaction in M2a bone marrow aspirate smears was diffused and parvogranular,yet it appeared local and clumping in M2b.Clonal chromosomal abnormalities were found in 18 patients(78.3%,18/23).there were not concordant chromosomal aberrations in 16 cases with M2a patients.Specific chromosomal abnormalities with t(8;21) translation were all found in 7 cases with M2b patients,and following chromosomes y loss in 3 cases.Conclusion: AML-M2 is a series of heterogeneous diseases,a distinctive Morphologic,cytochemical and Cytogenetic features can be observed between patients with M2a and M2b.