论文部分内容阅读
目的:探讨急性早幼粒细胞白血病(APL)患者早期死亡的临床特点。方法:分析早期死亡APL患者形态学、免疫分型、染色体核型和PML/RARα融合基因特点,并详细记录年龄、性别、起病时白细胞(WBC)计数、血小板(BPC)计数、血红蛋白(Hb)含量、骨髓中早幼粒白血病细胞占单个核细胞百分比(BMLP%)、纤维蛋白原浓度(Fib)等。结果:63例APL患者中13例早期死亡,早期死亡率20.63%。13例早期死亡APL中,7例起病时外周血白细胞大于10×109L-1,9例形态学上表现为M3v,8例为CD34+,8例为CD2+,9例PML/RARα融合基因BCR3亚型,与非早期死亡组相比形态学、免疫分型、染色体核型和PML/RARα融合基因特点等存在统计学差异。除1例死于维甲酸综合征外,其余12例均死于脑出血。结论:外周血高白细胞,形态学表现为M3v、CD34+、CD2+和PML/RARα融合基因BCR3亚型APL早期死亡率极高,临床预后差。
Objective: To investigate the clinical features of early death in patients with acute promyelocytic leukemia (APL). Methods: Morphology, immunophenotyping, chromosomal karyotyping and PML / RARα fusion gene were analyzed in patients with early death APL. Age, sex, white blood cell count (WBC), platelet count (BPC), hemoglobin ) Content, promyelocytic leukemia cells in mononuclear cells (BMLP%), fibrinogen concentration (Fib) and so on. Results: Thirteen of 63 patients with APL died early, with an early mortality rate of 20.63%. Thirteen cases of early death APL had peripheral blood leukocytes larger than 10 × 109L-1 in 1,9 cases, M3v in morphology, CD34 + in 8 cases, CD2 + in 8 cases and BCR3 in 9 cases with PML / RARα fusion gene There were significant differences in morphology, immunophenotyping, chromosome karyotype and PML / RARα fusion gene characteristics compared with non-early death group. Except 1 patient died of retinoic acid syndrome, the remaining 12 patients died of cerebral hemorrhage. CONCLUSION: The peripheral blood leukocytes are characterized by high early mortality rate and low clinical prognosis in the subtype of APR with M3v, CD34 +, CD2 + and PML / RARα fusion genes.