532例髓性白血病和骨髓发育不良综合征患者的细胞遗传学异常。捷克斯洛伐克MDS合作小组。

Czechoslovak medicine Pub Date : 1990-01-01
K Michalová, J Musilová, Z Zemanová
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引用次数: 0

摘要

对170例慢性髓性白血病(CML)患者、107例慢性髓性白血病(CP)患者、63例母细胞期(BP)患者、187例“新生”急性髓性白血病(AML)患者和175例骨髓增生异常综合征(MDS)患者、164例原发性MDS患者和11例继发性MDS患者进行细胞遗传学检查。所有CML患者均为Ph阳性,29%的CP患者和71%的BP患者确定有额外的染色体改变。最常见的染色体异常是8三体,Ph值增加,i(17q)和Y染色体缺失。Ph染色体为CP孤立染色体异常的患者病程较好,获得性染色体畸变137例(73.3%)。除了根据AML的特定亚型描述的特定染色体变化外,我们还关注非随机染色体异常的评估,特别是涉及5号和7号染色体的异常。33例(17.6%)患者染色体数量和形态发生改变。在MDS患者中,68.8%的患者发现异常染色体克隆,68例患者发现涉及5号和/或7号染色体(占所有检查的38.8%)。AML中这些异常的频率与其他研究引用的结果没有显著差异。然而,在我们的MDS患者中,这些所谓的“诱变相关”染色体异常明显比迄今为止发表的所有研究更频繁。细胞遗传学检查的预后价值是根据骨髓细胞中存在正常和异常染色体克隆的患者的累积生存来评估的。
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Cytogenetic abnormalities in 532 patients with myeloid leukemias and myelodyplastic syndrome. The Czechoslovak MDS Cooperative Group.

A total of 170 patients with chronic myeloid leukemia (CML), 107 in chronic phase (CP) and 63 in blastic phase (BP) of the disease, 187 patients with "de novo" acute myelogenous leukemia (AML) and 175 patients with myelodysplastic syndrome (MDS), 164 patients with primary and 11 with secondary MDS, were cytogenetically examined. All patients with CML were Ph positive, additional chromosomal changes were ascertained in 29% of patients in CP and in 71% of patients in BP. The most frequent chromosomal abnormalities were trisomy 8, additional Ph, (i(17q] and loss of Y chromosome. More favorable course of the disease was observed for group of patients with Ph chromosome as solitary chromosomal abnormality in CP. Acquired chromosomal aberrations were proved in 137 patients with AML (73.3%). Except specific chromosomal changes delineated according to the specific subtype of AML we were concerned with evaluation of nonrandom chromosomal abnormalities, specially those involving chromosome 5 and 7. Numerical and morphological changes of those chromosomes were found in 33 patients (17.6%). In MDS patients abnormal chromosomal clones were found in 68.8% of patients, those involving chromosome 5 and/or 7 in 68 patients (38.8% of all examined). The frequency of these abnormalities in AML does not differ significantly from the results quoted by the other studies. However, in our MDS patients these so called "mutagen-associated" chromosome abnormalities were significantly more frequent than in all studies published so far. Prognostic value of cytogenetic examination was evaluated on the basis of cumulative survival of patients with normal and abnormal chromosomal clones present in bone marrow cells.

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