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慢性髓性白血病、多发性骨髓瘤和慢性淋巴细胞白血病在疾病各阶段的骨髓纤维化发病率。

Incidence of Myelofibrosis in Chronic Myeloid Leukemia, Multiple Myeloma, and Chronic Lymphoid Leukemia during Various Phases of Diseases.

作者信息

Dolgikh T Yu, Domnikova N P, Tornuev Yu V, Vinogradova E V, Krinitsyna Yu M

机构信息

Institute of Molecular Pathology and Pathomorphology, Novosibirsk, Russia.

出版信息

Bull Exp Biol Med. 2017 Feb;162(4):483-487. doi: 10.1007/s10517-017-3645-x. Epub 2017 Feb 27.

Abstract

Pathomorphological study of trephinobiopsy specimens from 129 patients with lymphoproliferative and myeloproliferative diseases was carried out over the course of chemotherapy. Combinations of initial and manifest myelofibrosis (loose network of reticulin fibers and extensive network of reticulin and collagen fibers, respectively) predominated at the debut of chronic myeloid leukemia, chronic lymphoid leukemia, and multiple myeloma. Manifest myelofibrosis was detected in patients with chronic myeloid leukemia without hematological response (failure of normalization of hematological values) and in patients with progressing and relapsing multiple myeloma. Combinations of foci of initial and manifest myelofibrosis were most incident in patients with progressing and relapsing chronic lymphoid leukemia. The incidence of myelofibrosis was higher in patients with multiple myeloma and chronic lymphoid leukemia progression and relapses and in patients with chronic myeloid leukemia without hematological response than at the disease debut and in case of response to chemotherapy. The response to chemotherapy in patients with chronic myeloid leukemia and chronic lymphoid leukemia was associated with a decrease in the incidence of myelofibrosis. In patients with multiple myeloma responding to chemotherapy, the incidence of myelofibrosis did not change in comparison with the disease debut.

摘要

在化疗过程中,对129例淋巴增殖性疾病和骨髓增殖性疾病患者的环钻活检标本进行了病理形态学研究。在慢性髓性白血病、慢性淋巴细胞白血病和多发性骨髓瘤初发时,以初始期和明显期骨髓纤维化(分别为疏松的网状纤维和广泛的网状纤维及胶原纤维网络)的组合为主。在无血液学反应(血液学指标未恢复正常)的慢性髓性白血病患者以及进展期和复发期的多发性骨髓瘤患者中检测到明显期骨髓纤维化。初始期和明显期骨髓纤维化病灶的组合在进展期和复发期的慢性淋巴细胞白血病患者中最为常见。与疾病初发时及化疗有反应的情况相比,多发性骨髓瘤、慢性淋巴细胞白血病进展和复发患者以及无血液学反应的慢性髓性白血病患者中骨髓纤维化的发生率更高。慢性髓性白血病和慢性淋巴细胞白血病患者对化疗的反应与骨髓纤维化发生率的降低有关。在对化疗有反应的多发性骨髓瘤患者中,骨髓纤维化的发生率与疾病初发时相比没有变化。

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