慢性粒细胞白血病(儿童)128例染色体核型分析

治疗无效者 5 例 （均染色体复杂异常），治疗后 6 个月内死亡 1 例。结论 分析慢性粒细胞白血病核型对判断白血病患者预
后具有重要临床价值，附加染色体的复杂程度越高，提示该患者预后可能越差。
关键词：慢性粒细胞白血病；儿童白血病；染色体核型中图分类Βιβλιοθήκη ：R733.72文献标识码：B
Karyotype analysis of 128 cases of chronic myeloid leukemia (children)
一般较长，其生存期普遍在 3~5 年间，而且对放 化疗均高度抗拒，多经伊马替尼等药物治疗，治 疗难度较大，而分析核型有助于了解病情严重程 度，判断预后情况。本次研究选择 2014 年 2 月至
收稿日期 : 2018-09-11
· 52 ·
WANG Jin [Zhenzhou Institute of Pediatrics, Children's Hospital Affiliated to Zhengzhou University (Henan Children's Hospital,
Zhengzhou Children's Hospital, Zhengzhou, Henan 450018, China]
［郑州大学附属儿童医院 （河南省儿童医院、郑州儿童医院） 儿研所， 河南 郑州 450018］
摘要：目的 分析慢性粒细胞白血病 （儿童） 128 例染色体核型。方法 选择 2014 年 2 月至 2017 年 1 月在该院接受治疗
的慢性粒细胞白血病患者 128 例，患者骨髓及外周血液样本经培养后，采用 R 显带技术分析染色体核型。急变期积极治疗
Keywords: chronic myeloid leukemia; childhood leukemia; karyotype
慢性粒细胞白血病在青少年及儿童中较为少 见，病因也尚未完全清楚。近年来，发病率呈上 升趋势，一旦发病对患儿的身心健康影响巨大， 故需引起足够的重视 ［1-3］。慢性粒细胞白血病病程
者随访 6 个月，以 6 个月内患者死亡或 6 个月为随访截止。结果 128 例慢性粒细胞白血病患者中包含 pH 阳性者 115 例
（89.84%），pH 染色体阴性者 13 例 （10.16%）；而 pH 阳性者中，变异型 8 例 （6.96%），染色体核型演变者 25 例 （21.74%），
包括急变期 20 例 （68.97%）、慢性期 4 例 （4.17%） 及加速期 1 例 （33.33%）；急变期 29 例中积极化疗者 10 例，完全缓解者 4 例，
第 27 卷第 7 期 2019 年 7 月
DOI: 10.19338/j.issn.1672-2019.2019.07.014
中国医学工程 China Medical Engineering
Vol.27 No.7 Jul. 2019
·临床研究·
慢性粒细胞白血病 （儿童） 128 例染色体核型分析
王金
Abstract: 【Objective】 To analyze 128 karyotypes of chronic myeloid leukemia (children). 【Methods】 A total of 128 patients with chronic myeloid leukemia who were treated in our hospital from February 2014 to January 2017 were selected. Chromosome karyotypes were analyzed by R-banding technique after bone marrow and peripheral blood samples were cultured. Patients who were actively treated during the blast phase were followed up for 6 months, and part of them died within 6 months. 【Results】Of the 128 patients with chronic myeloid leukemia, 115 (89.84%) were pH-positive, 13 (10.16%) were pH-negative, and 8 cases (6.96%) were variants among pH-positive, 25 cases (21.74%) were karyotype evolvers, including 68.97% (20/29) in the blast phase, 4.17% (4/96) in the chronic phase, and 33.33% (1/3) in the accelerated phase; there were 10 patients treated with active chemotherapy, including 4 patients with completely remission, 5 patients with ineffective treatment (all chromosome complex abnormalities), and 1 patient died within 6 months after treatment.【Conclusion】Analysis of chronic myeloid leukemia karyotype has important clinical value for judging the prognosis of leukemia patients. The higher the complexity of additional chromosomes, the worse the prognosis may be.