急性单核细胞白血病m5a和m5b细胞遗传学与临床

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1、急性单核细胞白血病M5a和M5b细胞遗传学与临床【摘要】　　为了比较急性单核细胞白血病M5a和M5b细胞遗传学差异，并研究其与临床行为之间的相互关系，采用骨髓直接法和24小时短期培养法制备染色体标本，用G显带技术对58例成人初发急性单核白血病细胞进行核型分析，同时对其临床资料进行回顾性研究。结果表明：58例患者中正常核型28例，异常核型30例，其中正常核型在M5b中出现率高于M5a（P＝0.0001），异常核型中11q23异常和＋8染色体在M5a中均较M5b常见（P<0.01）；临床上异常核型的M5患者常有高白细胞（5a和M5b似乎具有各自独特的遗传学背景和

2、临床表现。【关键词】急性单核细胞白血病；AML-M5a；AML-M5b；细胞遗传学　　parisonofCytogeicsandClinicalManifestationsbetia　　AbstractToparethecytogeicdifferencebetonocyticleukemiaandtostudythecorrelationbetanifestations，atotalof58casesofdenovoadultAMLM5havebeeninvestigated.Chromosomemetaphasesofbonemarroethodand24ho

3、ursshort-termculture.Thekaryotypesationofthesecasesalkaryotypeand30alkaryotypeinpatientsy8oremoninpatientsedullarycentralnervesysteminfiltration，loission(CR)rateandshorteroverallsurvival.Itisconcludedthatacutemonocyticleukemiaisaseriesofheterogeneousdiseases，adistinctivecytogeicfeatur

4、escanbeobservedbetechanismofAMLM5atmolecularlevel.　　Keyonocyticleukemia;AML-M5a;AML-M5b;cytogeicsAcutemyeloidleukemia(AML)canbeclassifiedbyFABsystemintodifferentgroupsbasedoncellularmorphologyandcytochemistrystainingofbonemarroonocyticcells，acutemonocyticleukemia(AML-M5)consistsoftono

5、blastsis≥80%;M5b，themajorityofmonocyticcellsarepromonocytes（blasts＜80%）［1］.Inaddition，hematologicalmalignanciescanbeclassifiedaslymphocytic，myeloid，histocyticandmastocyticseriesbasedontheoriginofmalignantcellsbytheinedbymorphology，cytogeicsandclinicalcharacteristics.Hoscannotbeusedtod

6、ifferentiatethecytogeiccharacteristicsandclinicalmanifestationsbetanifestationsofthesepatientsformoreaccurateclassificationandunderstandingofthepathogene-sisofthedisease，entofanoveltherapeuticstrategy.　　MaterialsandMethods　　Patients　　DuringtheperiodfromJanuary2000toJune2004，58patients

7、entofHematologyofUnionHospitalaffiliatedtoTongjiMedicalCollege，HuazhongUniversityofScienceandTechnology(LM5apatients，agedfrom18to59edianageof39.5，alesand12femalesofAMLM5bpatientsagedbetedianageof48.　　Cytogeicanalysis　　2-3mlsofheparinizedbonemarropatientsentedand20U/mlheparin.Thecellde

8、nsity