Mirto S, Santoro A, Barbata G, Crescimanno A, Buscemi F, Carbone P, Caronia F
Dipartimento di Ematologia, Ospedale V. Cervello, USL 60, Palermo, Italy.
Haematologica. 1992 Nov-Dec;77(6):484-6.
Karyotype in ANLL is referred as an independent prognostic factor. The prognosis of diploid ANLL subjects has been defined as "good" by some authors, or, more recently, "intermediate" by others. This is a retrospective study on 30 consecutive heavy treated ANLL diploid patients with the aim to make a correlation among age, normal karyotype and response. Chromosomal banding studies were performed at presentation with GTG technique. Diploid patients were divided into two age groups < 60 years (17 cases) and > or = 60 (13 cases). Data were analyzed by NCSS software.
CR rate for the two diploid age groups was 94% and 38% respectively (p = 0.002). Median DFS and overall survival were 14.4 and 23.3 months, 4 and 5 months for the two subgroups respectively: these data were not statistically significative. The probability of achieving CR was not affected by blood counts and Karnofsky performance status on admission, but only by age. Though ANLL patients with the same karyotype have the same course regardless of other prognostic factors, this does not occur in our series of diploid patients. We suggest that a normal karyotype, at least as defined with the GTG technique, does not characterize a homogeneous group of patient. Heterogeneity in this group might be due to submicroscopic or molecular genetic changes; it can enhance the age as prognostic factor.
急性非淋巴细胞白血病（ANLL）的核型被视为一个独立的预后因素。一些作者将二倍体ANLL患者的预后定义为“良好”，而最近其他一些作者则定义为“中等”。这是一项针对30例连续接受强化治疗的二倍体ANLL患者的回顾性研究，目的是探讨年龄、正常核型与缓解之间的相关性。在初诊时采用GTG技术进行染色体显带研究。二倍体患者被分为两个年龄组：<60岁（17例）和≥60岁（13例）。数据采用NCSS软件进行分析。
两个二倍体年龄组的完全缓解（CR）率分别为94%和38%（p = 0.002）。两个亚组的中位无病生存期（DFS）和总生存期分别为14.4个月和23.3个月、4个月和5个月：这些数据无统计学意义。达到CR的概率不受入院时血细胞计数和卡氏功能状态的影响，仅受年龄影响。尽管具有相同核型的ANLL患者无论其他预后因素如何都有相同的病程，但在我们这组二倍体患者中并非如此。我们认为，至少按照GTG技术定义的正常核型，并不能表征一组同质的患者。该组中的异质性可能是由于亚微观或分子遗传变化；它可能会强化年龄作为预后因素的作用。
