白血病前期患者临床及实验室特征的研究

目的 探索前瞻性诊断白血病前期（白前）的指标和方法。方法 采用同期病例对照研究，以慢性再生障碍性贫血（ＣＡＡ）和不发作型阵发性睡眠性血红蛋白尿症（ａ－ｐＮＨ）为对照组，分析２１例白前患和临床和实验室特征与对照组弹的差异。结果 白前ＣＡＡ，ａ－ＰＮＨ相比较，可以有以下特点：（１）骨髓涂片可见或经微巨核酶标证实有淋巴微巨核细胞；（２）外周血中出现幼稚粒细胞；（３）骨髓原始粒细胞≥０．２０；（４）骨髓

Study on clinical and laboratory features of preleukemia patients

OBJECTIVE: To explore prospective diagnostic criteria for preleukemia. METHODS: A case control study of the discrepancies of clinical and laboratory features between patients with preleukemia and those with chronic aplastic anemia (CAA) or atypical paroxysmal nocturnal hemoglubinuria (a-PNH). RESULTS: There were eight variables of significance: (1) lymphocytoid micromegakaryocytes in marrow; (2) immature granulocytes in peripheral blood; (3) >or= 2% myeloblasts in marrow; (4) positive periodic acid schiff (PAS) staining of nucleated erythrocytes; (5) myeloid differentiation index >or= 1.8; (6) clonal karyotypic abnormalities; (7) negative sister chromatid differentiation; (8) > 4.0 cluster/colony ratio of granulocyte-macrophage colony-forming units (CFU-GM). The following criteria was assigned: A: To meet (1) and at least two of the other seven variables; B: To meet at least four of the eight variables. All of the patients with preleukemia met A or B and none of the patients with CAA or a-PNH did. CONCLUSION: Preleukemia is different from CAA or a-PNH. It has its own clinical and laboratory features, which may be useful for prospective diagnosis.