Balogh E, Oláh E, Kovács I
Department of Paediatrics, University Medical School, Debrecen, Hungary.
Acta Paediatr Hung. 1990;30(2):271-89.
Cytogenetic analyses were performed on 43 children with acute lymphoblastic leukemia (ALL) before starting the therapy. Evaluable metaphases were obtained in 26 cases (60.46 %). The prognostic value of the initial chromosome picture and that of the different non-cytogenetic prognostic features was studied. In 14 out of 26 children (53.85 %) clonal chromosomal aberrations were found. The prognosis in the normal and normal/abnormal groups was significantly better than in patients with only abnormal cells. They found the remission rate of the diploid and hyperdiploid groups to be better and the survival duration significantly longer than in the pseudodiploid patients. Studying the correlation between the cytogenetic and non-cytogenetic findings the diploidy and hyperdiploidy seems to associate with low risk factors, while pseudodiploidy with high risk factors. When opposite cytogenetic and non-cytogenetic prognostic parameters were associated, the outcome of disease was determined by the cytogenetic picture. In eight patients out of the 14 children with abnormal karyotype various specific aberrations were found. While patients with specific translocations had a poor prognosis, the prognosis of the patients with 6q- was relatively good. The findings support the necessity of chromosome examination in all the children with ALL at diagnosis in order to distinguish the poor risk patients from the good ones.
对43例急性淋巴细胞白血病(ALL)患儿在开始治疗前进行了细胞遗传学分析。26例(60.46%)获得了可评估的中期分裂相。研究了初始染色体图谱以及不同非细胞遗传学预后特征的预后价值。26例患儿中有14例(53.85%)发现了克隆性染色体畸变。正常组和正常/异常组的预后明显好于仅含异常细胞的患者。他们发现二倍体和超二倍体组的缓解率更高,生存期明显长于假二倍体患者。研究细胞遗传学和非细胞遗传学结果之间的相关性发现,二倍体和超二倍体似乎与低风险因素相关,而假二倍体与高风险因素相关。当细胞遗传学和非细胞遗传学预后参数相反时,疾病的结局由细胞遗传学图谱决定。在14例核型异常的患儿中有8例发现了各种特定的畸变。虽然具有特定易位的患者预后较差,但6q-患者的预后相对较好。这些发现支持了对所有ALL诊断患儿进行染色体检查的必要性,以便区分低风险和高风险患者。