论文部分内容阅读
目的 初步探讨慢性粒细胞白血病（慢粒）的分期、分型和治疗。方法 分析了６０ 例患者的临床资料，并用 Ｒ 显带技术检查了４９ 例患者的染色体核型，用逆转录聚合酶链反应法检查了１３ 例 Ｂ Ｃ Ｒ Ａ Ｂ Ｌ融合基因。结果 慢粒急变期 Ｈｂ 和 Ｂ Ｐ Ｃ明显低于慢性期； Ｐｈ（－ ）５ 例（１０．２％ ）， Ｐｈ（＋ ）４４ 例（８９．８％ ）；慢粒急变患者有额外染色体异常 １０ 例（６６．７％ ）；５ 例行异基因骨髓移植术后转为正常核型；８ 例 Ｐｈ（＋ ）患者 Ｂ Ｃ Ｒ Ａ Ｂ Ｌ基因亦阳性，５ 例 Ｐｈ（－ ）患者有２ 例（４０％ ）阳性；慢粒急变者经治疗达完全缓解１０ 例（４３．４％ ）。结论 染色体检查及 Ｂ Ｃ Ｒ Ａ Ｂ Ｌ融合基因检测有助于慢粒的诊断、鉴别诊断、预测急变和判断疗效。异基因骨髓移植是根治慢粒的有效方法。
Objective To investigate the staging, classification and treatment of chronic myelogenous leukemia (CML). Methods The clinical data of 60 patients were analyzed. The karyotype of 49 patients was examined by R banding technique. Thirteen B C R A B L fusion genes were examined by reverse transcription polymerase chain reaction. Results Hb and B P C were significantly lower in the CB stage than in the chronic stage; Ph(-) in 5 cases (10.2%) and Ph(+) in 44 cases (89.8%); there were additional chromosomal abnormalities in patients with CRM. 10 cases (66.7%); 5 cases of normal karyotype after allogeneic bone marrow transplantation; 8 cases of Ph(+) B C R A B L gene were also positive, 5 cases of Ph(-) patients Two cases (40%) were positive; those who had chronic granule change achieved complete remission in 10 cases (43.4%). Conclusion Chromosomal examination and B C R A B L fusion gene detection are helpful for the diagnosis, differential diagnosis, rapid change prediction, and judgment of curative effect. Allogeneic bone marrow transplantation is an effective method to cure chronic granules.