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本文对46例骨髓增生异常综合征(MDS)病人进行了连续的形态学和细胞遗传学研究。46例的FAB分型为:难治性贫血(RA)25例,获得性原因不明铁粒幼细胞贫血(AISA)11例,RA伴原始细胞过多(RAEB)5例,慢性粒单细胞白血病(CMML)3例,RAEB转化型(RAEBt)2例,当骨髓原粒细胞>30％即认为发展成为急性髓性白血病(AML)。随诊时间至少4个月,每例至少作过3次骨髓细胞形态学和细胞遗传学检查。除1例在转变为AML之前1年多进行过1个疗程(20天)的小剂量阿糖胞苷治疗外,其余在随诊期间均未接受过细胞抑制剂治疗。结果:21例(45.5％)演变为AML,呈两种演变类型:a)8例(占本组38％)骨髓原始细胞逐渐增加,发展成AML的中位时间是28个月(5—62个月),所有做了骨髓活检的7例患者未成熟粒系前体细胞的
In this paper, 46 cases of myelodysplastic syndrome (MDS) patients with continuous morphological and cytogenetic studies. Forty-six cases of FAB were classified as: refractory anemia (RA) 25 cases, acquired unexplained aneurysmal cell anemia (AISA) 11 cases, RA with excess blasts (RAEB) 5 cases, chronic myelomonocytic leukemia 3 cases of CMML and 2 cases of RAEBt were considered to develop acute myeloid leukemia (AML) when their myeloid granulocytes> 30%. Follow-up time of at least 4 months, each case made at least 3 times bone marrow cell morphology and cytogenetic examination. Except one case of low dose cytarabine treated more than one year (1 day) more than one year before the change to AML, all other cytostatics were not treated during the follow-up period. RESULTS: Twenty-one patients (45.5%) evolved into AML with two types of evolution: a) Eight patients (38% of the patients in this group) gradually increased bone marrow blasts and the median time to progression to AML was 28 months (range 5-62 Months), all of the 7 patients who underwent bone marrow biopsy had immature granulocyte precursors