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目的探讨伴有t(8;21)的成人急性髓系白血病(AML)的细胞遗传学特点及预后意义。方法分析我院检测的189例成人t(8;21)的细胞遗传学和临床预后特点。结果单纯t(8;21)(q22;q22)63例,占33.3%;伴有附加异常的126例,占66.7%;单纯性染色体丢失77例占总数的40.7%,其中-Y占男性患者的46.7%(63/135),-X占女性患者的25.9%(14/54)。有附加异常的126例中,单纯性染色体丢失77例(61.1%);9q-16例(12.7%);+4者5例(4.0%);7q-6例(4.8%);四倍体(4N)2例(1.6%);变异易位7例(5.6%)。此组患者的缓解率较高(87.0%),生存期较长(中位生存期21.6个月)。附加异常中+4和4N组预后较差。荧光原位杂交技术是诊断t(8;21)AML较为准确和可靠的方法,特别是对于变异易位、复杂易位和隐匿变异易位的病例。结论t(8;21)常合并附加异常,附加异常的种类会影响t(8;21)AML患者的预后。
Objective To investigate the cytogenetic characteristics and prognostic significance of adult acute myeloid leukemia (AML) accompanied by t (8; 21). Methods The cytogenetics and clinical prognosis of 189 adult patients (8; 21) detected in our hospital were analyzed. Results T (8; 21) (q22; q22) was 63 cases (33.3%), with 126 cases with additional abnormalities (66.7%) and 77 cases with simple chromosome loss (40.7%), of which -Y accounted for male patients Of the 46.7% (63/135), - X accounted for 25.9% of female patients (14/54). There were 77 cases (61.1%) of simple chromosome loss in the 126 cases with additional abnormalities, 9q-16 cases (12.7%), 5 cases (4.0%) of 4 cases, 7q-6 cases (4N) in 2 cases (1.6%); variant translocation in 7 cases (5.6%). This group of patients with high response rate (87.0%), longer survival (median survival 21.6 months). In the additional abnormalities, the prognosis of +4 and 4N groups was poor. Fluorescent in situ hybridization is a more accurate and reliable method for the diagnosis of t (8; 21) AML, especially for cases of translocation, complicated translocation and occult translocation. Conclusions t (8; 21) often associated with additional abnormalities, additional abnormalities affect the prognosis of t (8; 21) AML patients.