慢性粒细胞白血病合并骨髓纤维组织增生44例报道

报道１９７２年～１９９１年中收治４４例慢粒合并骨髓纤维化病人，发病率占同期慢粒收治总数１８３例中的２４％。临床以脾肿大更为突出。病理上髓纤分三度：Ⅰ度骨髓中仅少量纤维组织增生；Ⅱ度骨髓中广泛弥散纤维组织增生；Ⅲ度骨髓广泛纤维组织增生伴骨质增生。慢粒慢性期：Ⅰ度２４例，Ⅱ度１例；加速期：Ⅱ度２例；急变期：Ⅰ度１３例；Ⅱ度４例。认为慢粒合并髓纤预后不一定全部差，视髓纤出现在慢粒分期不同而异。

AN CASE REPORT OF MYELOFIBROSIS CHRONIC GRANULOCYTIC LEUKEMIA OF 44 CASES

e reported 44 cases of CML with myelofiborosis from 1972 to 1991,24%of total cases of CMLduring the same period of time. In our experience ,we found the disease is not rare.Splenomegaiy is a very prominent feature in these cases, more marked than those withoutmyelofibrosis. In pathological specimens , the extent of myelofibrosis could be put into three grades : 37cases showed grade 1 , among which 24 cases were in chronic phase and 13 cases in blastictransformation. The fibrosis in grade one is only minimal.Grade 2 is interstitial type with morediffuse fibrosis. In this grade ,the total number is 7 cases , of which 1 in chronic phase and 2 inaccelerated phase and another 4 in blastic transformation,In grade 3 ,the prominent feature isosteosclerosis,the myelofibrosis is minimal and not marked. In our study, we found that the eixstenceof myelofibrosis is not necessarily a grate prognostic sign. There was not any close correlation betweenthis pathological finding and its eventual outcome. This might appear both in chronic and acceleratedphases