Zingg K, von Rohr A, Fey M F, Tobler A
Hämatologisches Zentrallabor der Universität, Inselspital Bern.
Schweiz Med Wochenschr. 1994 Jan 11;124(1-2):51-5.
Bone marrow examination yields valuable diagnostic information for evaluation of treatment efficacy in acute myelogenous leukemia (AML) patients. However, the ideal timing of this procedure remains to be defined. Usually the first follow-up examination is performed on day 17 of the induction course. Since an earlier analysis might be helpful in deciding on the subsequent treatment strategy, we explored whether an examination on day 8 might be equivalent, in particular in terms of quality of the specimen, as compared with that on day 17. In 10 AML patients undergoing the same induction treatment, bone marrow aspirates were examined prospectively at diagnosis (day 0), immediately after termination (day 8) and on day 17 of the first treatment course. We found that the number of cells not classifiable due to artifacts, as well as the otherwise non-evaluable cells, did not differ significantly in aspirates obtained on day 8 as compared with those on day 17. The number of leukemic cells decreased significantly from day 0 to day 8, whereas no change was noted between days 8 and 17. We conclude that a marrow examination on day 8 is not more prone to misinterpretation due to artifacts than our standard examination on day 17. Thus, an early marrow analysis immediately after completion of the first induction cycle might be a helpful tool in evaluating course of AML.
骨髓检查可为评估急性髓性白血病（AML）患者的治疗效果提供有价值的诊断信息。然而，该检查的理想时机仍有待确定。通常在诱导疗程的第17天进行首次随访检查。由于更早的分析可能有助于确定后续的治疗策略，我们探讨了与第17天的检查相比，第8天进行的检查是否在样本质量等方面具有同等效果。在10例接受相同诱导治疗的AML患者中，前瞻性地在诊断时（第0天）、首次治疗疗程结束后即刻（第8天）和第17天对骨髓穿刺物进行检查。我们发现，与第17天获得的穿刺物相比，第8天获得的穿刺物中因人为因素无法分类的细胞数量以及其他无法评估的细胞数量没有显著差异。白血病细胞数量从第0天到第8天显著减少，而在第8天和第17天之间没有变化。我们得出结论，与我们在第17天的标准检查相比，第8天的骨髓检查并不更容易因人为因素而产生误解。因此，在第一个诱导周期完成后立即进行早期骨髓分析可能是评估AML病程的一个有用工具。
