伴11号染色体异常的急性髓系白血病的临床和细胞遗传学研究

目的 研究11号染色体异常在急性髓系白血病中的发生率及与临床和预后的关系.方法 采用R带常规显带技术进行染色体检查,对356例急性髓系白血病患者的核型进行分析.结果 356例急性髓系白血病患者中检出11号染色体异常患者34例,占9.55%;其中20例(58.8%)涉及11q23,7例11p15易位(20.6%),5例-11(14.7%),其他少见的核型改变有:+11,t(11;14).11q23中,M4、M5占70%;且有10例同时合并有其他染色体异常.30例进行正规化疗的患者,13例缓解,缓解率低于同期急性髓系白血病的总缓解率(43.3% vs64.0%);伴11q23的急性髓系白血病的缓解率低于染色体正常的急性髓系白血病患者(45% vs67%);11q23伴其他染色体异常的缓解率低于伴单纯11q23者(30% vs60%).7例涉及11p15易位患者3例缓解,2例早期复发.5例-11患者缓解2例.结论 11q23是11号染色体异常中最为常见的核型改变,且多见于急性髓系白血病的M5型,并可能与急性单核细胞白血病的发病有关;伴11号染色体异常的急性髓系白血病患者预后较差.

Clinical and cytogenetics studies on acute myeloid leukemia with abnormality of chromosome 1

Objective To investigate the incidence of chromosome 11 abnormality in acute myeloid leukemia and its relationship with the clinical aspects and prognosis.Methods Conventional cytogenetic analysis of R-band was used to detect the abnormabties of chromosome 11 in 356 acute myeloid leukemia patients.Results Thirty-four out of 356 patients(9.55%)had abnormalities of chromosome 11,of which 20(58.8%)involved in 11q23,7(19.9%)had translocations involving 11p15,5(14.7%)had-11,and the rest had other abnormalifies such as+11,and t(11;14).The incidence of 11q23 involvement in M4 and M5 was higher than other subtypes of acute myeloid leukemia(AML).Ten cases with 11q23 abnormality had additional cytogenetic aberrations.In 30 cases treated with chemotherapy.13 cases acquired complete remission(CR).The CR rate was lower than that of whole eases of acute myeloid leukemia(34.3%versus64.0%).The CR rate of AML with 11q23 abnormality was lower than that of AML with normal karyotype(25%versus55.6%).In other 10 patients with additional chromosome aberrations,the CR rate was lower than that of AML with 11q23 alone.In 7 patients with translocations at 11p15,only 3 patients acquired CR.and 2 patients relapsed early.Only 2 patients acquired CR in 5 patients with-11.Conclusion 11q23 was a frequent aberration in chromosome 11 anomaly,which was often detected in M4 and M5.It might be associated with the pathogenesis of acute monolytic leukemia.The patients with chromosome 11 anomaly had poorer prognosis.