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袁翠英周敏谢品浩张谦董海波陈兰昕欧阳建△.慢性髓细胞白血病急变期MICM 分型回顾性分析[J].现代生物医学进展英文版,2011,11(19):3645-3647.
慢性髓细胞白血病急变期MICM 分型回顾性分析
Analysis of Morphology, Immunology, Cytogentic and Molecular BiologyClassification of Patients with Chronic Myeloid Leukemia in Blastic Crisis
  
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中文关键词: 慢性髓细胞白血病  急变  MICM 分型
英文关键词: Chronic myeloid leukemia  Blastic crisis  MICM analysis
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Author NameAffiliation
袁翠英周敏谢品浩张谦董海波陈兰昕欧阳建△ 南京大学医学院附属鼓楼医院 
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中文摘要:
      目的:探讨慢性髓细胞白血病急变期(CML-BC) 患者的细胞形态学(M)、免疫学(I)、细胞遗传学(C)和分子生物学(M)的特 征及应用价值。方法:对38 例CML-BC 患者的MICM 分型进行回顾性分析。结果:以FAB 分型为基础的形态学确诊率达94.7%; 免疫分型结果为:38 例CML-BC 中CML-AML 占71.0%,其中37.0%伴淋系表达;CML-ALL 占23.7%,均为B 细胞性,其中 66.67%伴髓系表达;CML-MAL(混合性白血病)占5.3%,均为B 系和髓系混合表达;CD34+26 例(68.4%),CD7+10 例(26.3%),均与 CD34 共表达。细胞遗传学结果显示:CML 特征性Ph 染色体检出率为94.3%(36/38),附加异常染色体检出率为60.5%(23/38),发 生频率较高的类型是+Ph、+8 和i(17q);FISH 检测BCR /ABL 融合基因阳性率为100%,der(9)缺失占14.7%。RT-PCR 检测20 例 患者BCR /ABL 融合基因均为阳性,其中b2a2 型(12/20),b3a2 型(8/20),1 例(1/20),b2a2 和b3a2 双阳性(1/20)。结论:CML-BC 是 造血干细胞疾病,原始细胞分化阻滞在早期阶段,预后差。MICM 分型对CML-BC 的诊断、治疗和预后判断均有重要价值。
英文摘要:
      Objective: To invistigate the characteristic and value of bone marrow morphology, immunology, cytogenetic and molecular biology (MICM) in patients with chronic myeloid leukemia in blastic crisis (CML-BC). Methods: 38 patients with CML-BC were studied by MICM analysis. Results: The accuracy rate of morphological diagonis based on FBA classification was 94.7%. Immunology results, the percentage of CML-AMLwas 71.0%, in which 37.0% patients expressed lympholytic associated antigen; The percentage of CML-ALL was 23.7% and all were B lypholytic immunophenotype, in which 66.7% patients expressed myeloid assuiated antigen; The percentage of CML-MALwas 5.3% with all expressing B lypholoid and myeloid immumphenotype. 26 cases (68.4%) had CD34 expression and 10 cases (26.3%) had CD7 and CD34 Co-expression. In cytogenetic result, the positive rate of Ph chromosome was 94.3%. Other chromosome abnomality rate was 60.5% with +ph,+8 and i (17q) in high appearance rate. The positive rate of BCR /ABL gene by FISH reached 100% with 14.7% del(9). The positive rate of BCR /ABLgene by RT-PCR also reached 100% with b2a3(12/20),b3a2(8/20) and b2a3+b3a2(1/20). Conclusion: CML-BC is a kind of disease of stem cell. The differentiation of blast cell is blocked in the early stage. MICM has great value in diangnosis, therapy and prognosis judgement.
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