Golomb H M, Vardiman J, Rowley J D
Blood. 1976 Jul;48(1):9-21.
Chromosome banding patterns were obtained for 50 of 55 consecutive adult patients with acute nonlymphocytic leukemia during a 5-yr period. Twenty-two of the 50 cases were diagnosed as acute myelocytic leukemia (AML), 24 as acute myelomonocytic leukemia (AMMol), 2 as acute promyelocytic leukemia (APL), and 2 as erythroleukemia. Twenty-five patients had initial chromosome abnormalities during the course of the disease. The median survival of patients with normal chromosomes initially (group I) was 10 mo, whereas that of patients with abnormal chromosomes initially (group II) was 2 mo. Similar times were obtained for treated patients with AML and AMMol. However, when the AML patients were separated into those with and those without a chromosome abnormality, the median survival times were markedly different (2 mo versus 18 mo, respectively). Patients with AMMol demonstrated no difference in median survival times when subgrouped according to the presence or absence of chromosome abnormalities. The treated group II patients whose marrow samples had only abnormal metaphases had a poorer response (10% complete remission) and median survival (2 mo) than the group II patients who had at least one normal metaphase (42% complete remission with a median survival of 9 mo). The two cases of APL demonstrated a deletion of the long arm of No. 17 which occurred in the same region of the chromosome in each case. Both patients had similar clinical histories, with disseminated intravascular coagulation, and neither responded to therapy.
在5年期间,对55例连续的成年急性非淋巴细胞白血病患者中的50例进行了染色体显带分析。50例患者中,22例被诊断为急性髓细胞白血病(AML),24例为急性粒单核细胞白血病(AMMol),2例为急性早幼粒细胞白血病(APL),2例为红白血病。25例患者在病程中出现初始染色体异常。初始染色体正常的患者(第一组)的中位生存期为10个月,而初始染色体异常的患者(第二组)的中位生存期为2个月。AML和AMMol的治疗患者也得到了类似的结果。然而,当将AML患者分为有染色体异常和无染色体异常两组时,中位生存期明显不同(分别为2个月和18个月)。AMMol患者根据染色体异常情况分组时,中位生存期无差异。骨髓样本仅见异常中期分裂相的第二组治疗患者的缓解率(10%完全缓解)和中位生存期(2个月)比至少有一个正常中期分裂相的第二组患者差(42%完全缓解,中位生存期9个月)。2例APL患者均显示17号染色体长臂缺失,且缺失发生在每条染色体的同一区域。两名患者有相似的临床病史,均有弥散性血管内凝血,且均对治疗无反应。