初发急性非淋巴细胞白血病的细胞遗传学研究

Wei C H, Luh Y M, Liu J H, Fan S, Hsieh R K, Chiou T J, Tzeng C H, Chen P M

Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi (Taipei). 1995 Apr;55(4):296-301.

BACKGROUND

There is currently considerable interest in the cytogenetic analysis of leukemia. The improvement of banding techniques has made it possible to rather precisely identify deletion, translocation, inversions, and other structural chromosome abnormalities. Specific recurring chromosome abnormalities associated with distinctive morphologic features are thus increasingly recognized in acute nonlymphocytic leukemia. For example, uneven geographic distribution of nonrandom specific chromosome aberrations has been reported. We herein report the results of chromosome studies on 30 Chinese patients with de novo acute nonlymphocytic leukemia.

METHODS

Cytogenetic studies were performed at Veterans General Hospital-Taipei, from 1988 to 1993, on unselected samples of 30 patients with de novo acute nonlymphocytic leukemia. Chromosome analysis was performed by short-term culture techniques on bone marrow material obtained from patients at diagnosis. Metaphase chromosomes were banded by the conventional trypsin-Giemsa banding technique and then karyotyped according to the International System for Human Cytogenetic Nomenclature (ISCN). Classification of leukemia was based on the criteria of the French-American-British cooperative group.

RESULTS

Of the 30 patients with adequate specimens, 17 (56%) demonstrated clonal chromosome abnormalities. Six patients were found to have structural rearrangements and seven patients have a numerical change as the sole abnormality. Four patients showed both structural and numerical anomalies. t(8;21) was found in 1 of the 8 M2 type ANLL patients and two of them had monosomy 21. Four of the 6 patients with acute promyelocytic leukemia (APL; M3 subtype) showed t(15;17). Two patients with M4 type leukemia and abnormal bone marrow eosinophils showed inv(16)(p13q22). One patient with M4 type leukemia demonstrated the loss of chromosome #7 and none showed the loss or deletion of chromosome #5.

CONCLUSIONS

This study revealed a consistent finding of t(15;17) in APL; however, a low incidence of t(8;21), -5/5q- and -7/7q- in our patients demonstrated the possible difference in the incidence of chromosomal abnormalities in ANLL between the oriental peoples and the whites.

背景

目前白血病的细胞遗传学分析备受关注。显带技术的改进使得相当精确地识别缺失、易位、倒位及其他染色体结构异常成为可能。因此，在急性非淋巴细胞白血病中，与独特形态学特征相关的特定复发性染色体异常越来越受到认可。例如，已有报道非随机特定染色体畸变存在不均衡的地理分布。我们在此报告对30例中国初发急性非淋巴细胞白血病患者进行染色体研究的结果。

方法

1988年至1993年，在台北荣民总医院对30例初发急性非淋巴细胞白血病患者的未选择样本进行了细胞遗传学研究。通过短期培养技术对诊断时从患者获取的骨髓材料进行染色体分析。中期染色体采用常规胰蛋白酶-吉姆萨显带技术进行显带，然后根据国际人类细胞遗传学命名系统（ISCN）进行核型分析。白血病的分类基于法美英协作组的标准。

结果

在30例有足够标本的患者中，17例（5�%）显示克隆性染色体异常。6例患者发现有结构重排，7例患者仅有数目改变这一唯一异常。4例患者同时显示结构和数目异常。在8例M2型急性非淋巴细胞白血病（ANLL）患者中，1例发现t(8;21)，其中2例有21号染色体单体。6例急性早幼粒细胞白血病（APL；M3亚型）患者中有4例显示t(15;17)。2例M4型白血病且骨髓嗜酸性粒细胞异常的患者显示inv(16)(p13q22)。1例M4型白血病患者显示7号染色体缺失，无患者显示5号染色体缺失或缺失。