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为分析79例成人Ph染色体阳性急性白血病(Philadelphiachromosomepositiveacuteleukemia,Ph+AL)的细胞遗传学和相关临床表现及预后,联合应用细胞形态学、免疫分型,骨髓细胞染色体G显带技术(morphology,immunology,cytogenetics,MIC),对1991年10月-2003年12月住本院的79例Ph染色体阳性急性白血病进行了随访。结果表明:Ph+AL总的检出率为6.9%,其中Ph染色体阳性急性淋巴细胞性白血病(Philadelphiachromosomepositiveacutelymphoblasticleukemia,Ph+ALL)56例,检出率18%,Ph染色体阳性急性髓细胞性白血病(Philadelphiachromosomepositiveacutemyeloidleukemia,Ph+AML)10例,检出率1.2%。Ph染色体阳性急性混合细胞性白血病(Philadelphiachromosomepositivemixedacuteleukemia,Ph+MAL)13例。56例Ph+ALL中52例免疫表型为B细胞型。10例AML中,包括M14例,M2、M4和M7各2例。13例Ph+MAL中12例混合表达髓系和B淋巴细胞系表型,另1例为髓系、T淋巴细胞系混合型。总的染色体附加异常检出率为54.4%,附加异常较多涉及到的染色体包括:7号、双Ph染色体、+8等。Ph+ALL组和Ph+MAL组缓解率为57.0%,Ph+AML组无1例达到缓解。Ph+ALL完全缓解率明显低于同期正常核型ALL对照组(P<0.05)。Ph+ALL、Ph+MAL组总的中位生存期均为10个月,Ph+AML
In order to analyze the cytogenetics and clinical manifestations and prognosis of 79 cases of adult Ph chromosome-positive acute leukemia (Ph + AL), the morphology, immunophenotyping, morphology and immunology of bone marrow cells, Cytogenetics, MIC), 79 patients with Ph-positive acute leukemia who lived in our hospital from October 1991 to December 2003 were followed up. The results showed that the overall detection rate of Ph + AL was 6.9%, of which 56 cases were Ph chromosome positive acute lymphocytic leukemia (Ph + ALL), the detection rate was 18%, Ph chromosome positive acute myeloid leukemia (Philadelphia chromosome positive acute leukemia leukemia , Ph + AML) in 10 cases, the detection rate was 1.2%. Ph chromosome positive acute mixed leukemia (Philadelphia Chromosomepositive mixed leukemia, Ph + MAL) in 13 cases. Fifty-six cases of Ph + ALL were immunophenotype B cells. 10 cases of AML, including M14 cases, M2, M4 and M7 in 2 cases. Thirteen Ph + MAL mixed expression of myeloid and B lymphocyte lineage phenotype, the other was myeloid, T lymphocyte lineage mixed type. The total rate of chromosomal anomaly detection was 54.4%. Additional anomalies involved chromosomes, including 7th, double Ph chromosomes, +8 and so on. In Ph + ALL group and Ph + MAL group, the remission rate was 57.0%, and none in Ph + AML group was relieved. The complete response rate of Ph + ALL was significantly lower than that of normal karyotype ALL control group (P <0.05). The overall median survival in Ph + ALL and Ph + MAL groups was 10 months, Ph + AML