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目的 :通过报道 7例成人急性髓系白血病治疗后转型情况 ,揭示其细胞遗传学及临床特征。方法 :对 7例患者进行临床资料收集、分析以及染色体和融合基因检测。结果 :7例患者均有 FAB分类的形态学改变 ,其中 2例既有形态学改变 ,又有染色体变化 ;转型发生时间距第一次完全缓解时间 1个月～ 14个月 (平均 6 .33月 ) ;转型后 7例患者对化疗均不敏感。结论 :转型患者对化疗或诱导分化、凋亡治疗均不敏感 ,如能在 CR1 期动态监测微小残留病灶或发现复合染色体异常或出现新的染色体异常 ,积极采用大剂量化疗、造血干细胞移植 ,可能会延长患者的生存期。
OBJECTIVE: To report the cytogenetics and clinical features of 7 cases of acute myeloid leukemia after treatment. Methods: Clinical data collection, analysis and chromosomal and fusion gene detection were performed on seven patients. Results: All the 7 patients had morphological changes of FAB classification. Two of them had both morphological changes and chromosomal changes. The transitional time ranged from 1 month to 14 months after the first complete remission (average 6 .33 Month); 7 patients after chemotherapy are not sensitive to chemotherapy. CONCLUSIONS: Patients with transformation are not sensitive to chemotherapy or induction of differentiation and apoptosis treatment. If patients with minimal residual disease can be dynamically monitored during CR1 or have complex chromosomal abnormalities or new chromosomal abnormalities, high-dose chemotherapy and hematopoietic stem cell transplantation may be actively employed Will extend the patient’s survival.