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目的研究11q23异常成人急性白血病(AL)的实验室资料与其临床特征和预后的关系。方法对1992年8月至2003年11月中国协和医科大学血液学研究所收治的23例11q23异常的成人AL的临床和实验室资料进行回顾性分析。结果23例11q23异常的患者中14例为急性髓性白血病(AML),7例为急性淋巴细胞白血病(ALL),1例为急性杂合细胞白血病(HAL),1例为急性未分化白血病(AUL)。AML中以AML-M4及AML-M5为主,ALL中以前B-ALL为主。异常核型主要为11q23缺失(n=9)和t(4;11)(n=8)。23例AL的中位存活时间为175d,14例AML的中位存活时间为185d,7例ALL的中位存活时间为167d。结论11q23异常AL在成人主要见于AML-M4及AML-M5和前B-ALL,具有高白细胞、易于髓外浸润、化疗缓解率低、预后差等临床特点,为预后不良的细胞遗传学改变。
Objective To study the relationship between laboratory data of 11q23 abnormal adult acute leukemia (AL) and its clinical characteristics and prognosis. Methods The clinical and laboratory data of 23 AL patients with 11q23 abnormalities from August 1992 to November 2003 in Peking Union Medical College Hematology Institute were retrospectively analyzed. Results Of the 23 patients with 11q23 abnormality, 14 were acute myeloid leukemia (AML), 7 were acute lymphoblastic leukemia (ALL), 1 was acute hybrid cell leukemia (HAL) and 1 was acute undifferentiated leukemia AUL). AML to AML-M4 and AML-M5-based, ALL formerly B-ALL-based. Abnormal karyotypes were mainly 11q23 deletion (n = 9) and t (4; 11) (n = 8). The median survival time of 23 AL patients was 175 days. The median survival time of 14 AML patients was 185 days. The median survival time of 7 ALL patients was 167 days. Conclusion The abnormal 11q23 AL is mainly seen in AML-M4, AML-M5 and B-ALL in adults, with high white blood cell count, easy extramedullary infiltration, low response rate and poor prognosis. It is a cytogenetic change with poor prognosis.