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[慢性B细胞淋巴细胞白血病中的细胞遗传学疾病及其与疾病临床生物学特征和预后的关系]

[Cytogenetic disorders in chronic B-cell lymphoid leukemia and their relations with clinicobiological features and prognosis of the disease].

作者信息

Zakharova A I, Obukhova T N, Lorie Iu Iu, Nikitin E A, Samoĭlova R S, Zingerman B V, Domracheva E V

出版信息

Ter Arkh. 2006;78(7):57-62.

Abstract

AIM

To study a relationship between cytogenetic disorders, clinicobiological characteristics and prognosis in chronic B-cell lymphoid leukemia (B-CLL).

MATERIAL AND METHODS

Cytogenetic examination of blood, bone marrow and lymph node cells from 135 patients (90 males and 45 females aged 23-84 years) with chronic B-CLL was made. The patients were followed up from 1 month to 25 years. Before the cytogenetic examination specific therapy was not given. B-CLL was staged by K. Rai, forms--by A.L. Vorobyev and M.D. Brilliant. All the patients have undergone standard cytogenetic examination, FISH with multicolor probe to loci with possible frequent aberrations (del3q14, del11q23, del17p13, trisomia 12), determination of CD38 antigen expression on circulating tumor cells. Mutation status of the genes of immunoglobulins variable region (IgVH) was defined in 61 patients.

RESULTS

Del13q14 was detected in 34 cases, del11q23--in 26, trisomia of chromosome 12--in 17 cases, del 17p13--in 8, absence of q-arm of chromosome 13--in 3 cases. 61 patients had no karyotype defects. Three prognostic groups of the patients were identified: favourable prognosis--patients without disorders of karyotype and one chromosomal aberration--del13q14; intermediate prognosis patients with dell1q23 and trisomia of chromosome 12; poor prognosis--patients with del17p13 and complex disorders of karyotype. CONCLUSION. Cytogenetic study help determine prognosis of B-CLL and detect patients in need of early therapy.

摘要

目的

研究慢性B淋巴细胞白血病(B-CLL)的细胞遗传学异常、临床生物学特征与预后之间的关系。

材料与方法

对135例慢性B-CLL患者(90例男性,45例女性,年龄23 - 84岁)的血液、骨髓及淋巴结细胞进行细胞遗传学检查。对患者进行了1个月至25年的随访。在进行细胞遗传学检查之前未给予特殊治疗。B-CLL采用K. Rai分期,亚型采用A.L. 沃罗比耶夫和M.D. 布里利安特的分类方法。所有患者均接受了标准细胞遗传学检查、针对可能频繁出现异常的位点(del3q14、del11q23、del17p13、三体12)的多色探针荧光原位杂交(FISH)、循环肿瘤细胞上CD38抗原表达的测定。对61例患者进行了免疫球蛋白可变区(IgVH)基因突变状态的检测。

结果

检测到34例存在del13q14,26例存在del11q23,17例存在12号染色体三体,8例存在del17p13,3例存在13号染色体q臂缺失。61例患者无核型缺陷。确定了三组预后患者:预后良好组——无核型异常且仅有一种染色体异常(del13q14)的患者;预后中等组——存在del11q23和12号染色体三体的患者;预后不良组——存在del17p13和复杂核型异常的患者。结论:细胞遗传学研究有助于确定B-CLL的预后并发现需要早期治疗的患者。

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