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目的 探讨一种简便易行的检测急性白血病残留病变的方法。方法 对 2 7例急性白血病化疗后骨髓涂片首次完全缓解 (CR)时的骨髓切片进行同步观察 ,计数单位面积内原始细胞簇及原始细胞总数。原始细胞簇≥ 3 / mm2定为切片未完全缓解。结果 2 7例中 13例未达切片 CR,占 4 8%。切片中原始细胞总数与簇数呈显著正相关 ,r值 0 .918。切片缓解组完全缓解期明显长于未缓解组。对骨髓切片未 CR者继续行诱导化疗至原始细胞簇 <3 / mm2 ,再行巩固治疗及强化治疗 ,可明显延长 CR期。结论 骨髓切片内原始细胞簇计数检测急性白血病残留病变简便可靠 ,可真实反映诱导化疗后的骨髓缓解状况 ,弥补涂片结果之不足。
Objective To explore a simple and easy method for detecting residual disease in acute leukemia. METHODS: Bone marrow sections from 27 bone marrow smears after the first complete remission (CR) were simultaneously observed for chemotherapy in acute leukemia patients. The number of primitive cell clusters and the number of original cells per unit area were counted. The original cell cluster ≥ 3 / mm2 was determined as incomplete remission of the slice. Results Twenty-seven out of 27 cases did not reach slice CR, accounting for 48%. There was a significant positive correlation between the number of original cells in the section and the number of clusters, r value was 0.918. The complete remission period in the slice remission group was significantly longer than that in the unremission group. For patients with bone marrow without CR, induction chemotherapy was continued until the initial cell cluster was <3 / mm2. Consolidation treatment and intensive treatment were performed again, which significantly prolonged the CR period. Conclusion The detection of residual leukemia in acute leukemia is simple and reliable by counting the number of primitive cell clusters in bone marrow slices, which can truly reflect the bone marrow remission after induction chemotherapy and make up for the lack of smear results.