Department of Hematology, Atomic Disease Institute, Nagasaki, Japan.
Leuk Lymphoma. 1991;5(2-3):187-92. doi: 10.3109/10428199109068124.
To assess parameters of therapeutic response and survival after the onset of the blastic phase (BP) in 47 patients with Philadelphia chromosome (Ph)-positive chronic myeloid leukemia (CML), a number of clinical hematologic, and cytogenetic data at the BP were evaluated. Among the eleven parameters examined, only the chromosomal findings correlated with the therapeutic response and survival after onset of the BP. The patients were divided into three groups on the basis of the chromosome findings in the bone marrow: one, with only a Ph (PP), another with two different clones, i.e., one clone with Ph only and another with additional karyotypic changes (AP), and a third group with only abnormal clones containing karyotypic abnormalities in addition to the Ph (AA). The number of patients with AA was 12, 18 with AP, and 17 with PP. The results were as follows: (1) The percentage of patients with a good therapeutic response was 25% (3/12) in AA, 22% (4/18) in AP, and 76% (13/17) in PP; (2) The median survival after the onset of the BP was 1.5 mo for AA, 2.4 mo for AP, and 7.3 mo for PP. Statistically, there was a significant difference between PP and the other two groups (p < 0.05). These data were reevaluated and compared to those of 64 patients with Ph-positive CML in Roswell Park Memorial Institute (RPMI) who had been reported earlier in 1983.
为了评估 47 例费城染色体（Ph）阳性慢性髓系白血病（CML）患者发生急变期（BP）后的治疗反应和生存参数，评估了 BP 时的一些临床血液学和细胞遗传学数据。在检查的 11 个参数中，只有染色体发现与 BP 后治疗反应和生存相关。根据骨髓中的染色体发现，患者分为三组：一组仅存在 Ph（PP），另一组存在两个不同的克隆，即一个克隆仅存在 Ph，另一个克隆存在额外的核型改变（AP），第三组仅存在异常克隆，除 Ph 外还存在核型异常（AA）。AA 组患者有 12 例，AP 组有 18 例，PP 组有 17 例。结果如下：（1）AA 组治疗反应良好的患者比例为 25%（3/12），AP 组为 22%（4/18），PP 组为 76%（13/17）；（2）BP 后中位生存时间为 AA 组 1.5 个月，AP 组 2.4 个月，PP 组 7.3 个月。统计学上，PP 与其他两组之间有显著差异（p<0.05）。这些数据进行了重新评估，并与 1983 年以前 Roswell Park Memorial Institute（RPMI）报道的 64 例 Ph 阳性 CML 患者的数据进行了比较。
