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目的:探讨骨髓活组织检查在白血病自体造血干细胞移植(AHSCT)中的应用价值。方法:对23例白血病患者,在自体造血干细胞移植(AHSCT)前常规采用一步法,于髂后上棘进行抽吸涂片及活检取材,骨髓涂片进行常规检验,活体标本给予塑料包埋剂包埋,染色采用Wright、HGF或改良HGE染色。结果:23例患者骨髓涂片均获得CR,原始细胞比例≤5 %,而骨髓切片14例仍未获CR,占60.9 %。涂片原始细胞占2.2 %~4.6 %者6例,此组标本中切片原始细胞簇多见,且为大簇或片状分布。切片获CR者为9例,AHSCT后CR期时间为3 a ~ 13 a,平均为8 a,其中2例已分别生存13 a、12 a。结论:骨髓活检的CR为真正的CR,此时进行AHSCT,预后较好。此方法对于白血病进行AHSCT前的残留白血病细胞检测,具有方便、快捷、价格低廉的优点,值得推广。
Objective: To investigate the value of bone marrow biopsy in leukemia autologous hematopoietic stem cell transplantation (AHSCT). Methods: Twenty-three patients with leukemia were routinely treated with one-step method before autologous hematopoietic stem cell transplantation (AHSCT), aspiration smear and biopsy on the posterior superior iliac spine, and bone marrow smears were routinely tested. The living specimens were given plastic embedding agent Embedded, stained with Wright, HGF or modified HGE staining. Results: The bone marrow smears were obtained in all 23 patients with CR, the proportion of blasts was ≤5%, while the bone marrow slices were not found in 14 cases (60.9%). Smear primitive cells accounted for 2.2% to 4.6% in 6 cases, this group of specimens more primitive cell clusters, and large tufts or sheet distribution. There were 9 CR patients in the section and 3 a ~ 13 a CR after AHSCT with an average of 8 years. Two of them had been alive for 13 years and 12 months respectively. Conclusion: CR in bone marrow biopsy is true CR, and AHSCT is performed at this time, the prognosis is good. This method for the detection of residual leukemia cells before leukemia AHSCT, with the advantages of convenience, speed, low price, it is worth promoting.