MDS的治疗及其演变为急性白血病的先兆的探讨

本文分析60例MDS的临床资料,有12例转化为急性白血病,转白率20％.对演变为急性白血病的征兆进行探讨,发现MDS的单向转型、外周血中单核细胞数持续上升、骨髓像出现Auer小体可视为转白先兆;此外,电镜能更早发现白血病细胞.病理学有前期细胞位置或数量的改变、GM-CFU降低、染色体有畸变及治疗效果差者易转化为急性白血病.同时,对MDS的治疗方法进行分析,讨论了维甲酸对MDS的作用机制.

Treatment of Myelodysplastic Syndrome (MDS) and its Premonitors of Development into Acute Leukemia

Presented were the clinical data of 60 patients with MDS 12 of whom were transformed into acute leukemia (AL) with a transformation rate of 20%. It was found that the monotropy of MDS, a constant increase in the number of monocytes in peripheral blood and appearance of Auer's rods in blasts could be premonitories of leukemia transformation. In addition, lukemic cells can early be found by the electron microscope. Cases of MDS who showed abnormality of the location or quantity of homopoietic precursors, a decrease in the number of GM-CFU in vitro culture, appearance of chromosome aberrations and a poor therepentic respanse were prone to developing to acute leukemia. We discussed the therapies of MDS and mechanis(?)s of retinoic acid in treatment of MDS.