白血病ly+aml型和my+all型预后因素的临床研究 (6)

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1、红白血病——骨髓增生异常综合征的一种亚型？作者：牛奕，陈书长，江滨，李德高，葛昌文，李蓉生作者单位：中国医学科学院、中国协和医科大学北京协和医院肿瘤科；1北京大学人民医院血液科【摘要】　　为了研究红白血病是否为急性髓细胞白血病一个独立亚型，从临床实验及病程进展方面对21例红白血病患者进行了分析。结果显示，诊断时患者合并白细胞减少、贫血和血小板减少者分别为42.9%、81%、81%。外周血分类显示85.7%患者有幼稚粒细胞和幼稚单核细胞，52.4%患者有幼稚红细胞和有核红细胞；骨髓涂片显示骨髓增生活跃或明显活跃；红系细胞占58.3±8.0%，原始

2、粒细胞占NEC58.0±18.4%；66.7%患者有病态造血，与典型AML不同。在病程中52.4%患者发生疾病转型，转为RAEB/RAEBT和AMLM2，19例在确诊M6后接受化疗，11例有效（57.9%），其中CR10例、PR1例，CR中位维持6个月、PR2个月，但CR患者绝大多数伴有骨髓病态造血，外周血细胞减少。中数生存期在初诊M6和MDS转化为M6组分别为13.0±13.3和2.3±1.3月。结论：临床诊断急性红白血病与典型AML有许多差异，可能大部分是以红系过度增生为表现的MDSRAEB和RAEBT型。【关键词】红白血病；急性髓性

3、白血病；骨髓增生异常综合症　　Erythroleukemia——ASubtypeofMyelodysplasticSyndrome？NIUYi,CHENShuChang,JIANGBin1,LIDeGao,GEChangWen,LIRongShengDepartmentofOncology,PekingUnionHospital,ChineseAcademyofMedicalSciencesandPekingUnionMedicalCollege,Beijing100730,China;1DepartmentofHematology,P

4、ekingUniversityPeopleHospital,Beijing100034,ChinaAbstractInordertostudywhethererythroleukemiawasreallyasubtypeofacuteleukemia,theclinicallaboratorycharacteristicsanddevelopmentofdiseasein21casesoferythroleukemiawereanalyzed.Theresultsindicatedthatthepercentageofpatientswithl

5、eucocytopenia,anemiaandthrombocytopeniawere42.9%,81%and81%respectivelyatthetimeofdiagnosis.Thesewere85.7%ofpatientswithmyelocytesandpremonocyte,52.4%ofpatientswitherythroblastintheirbloodsmearrespectively.Allofthebonemarrowshowedactiveorsignificantlyactiveproliferation.Theme

6、dianpercentageoferythrolineage,myeloblastofNECanddisplasiawere(58.3±8.0)%,(58.0±18.4)%and66.7%respectively,thatisdifferentfromtypicalAML.52.4%ofM6patientstransferredtoRAEB/RAEBTandAMLM2subtypeinthediseaseprogression.11/19cases(57.4%)achievedremission(CR10;PR1)afterchemoth

7、erapy.Themedianremissionlengthwere6monthsforCRpatientsand2monthsforPRpatients,butmostofCRpatientsdisplayedobviousdisplasiaofbonemarrowandcytopeniaofbloodintheperiodofCR.ThemediansurvivallengthofM6andMDS→M6fromtimeofdiagnosiswere13.0±13.2and2.3±1.3monthsrespectively.Itisconcl

8、udedthattherearedifferencesbetweenM6andtypicalAML.MostofM6patientswouldrath