儿童近四倍体急性髓系白血病的实验室研究

Laboratory study on near-tetraploid acute myelogenous leukemia of childhood

摘要:

近四倍体在儿童髓系恶性肿瘤中是一种少见的遗传学异常，其意义还不清楚。该文就1例近四倍体的儿童急性髓系白血病（AML-M4）分析其特点。采用骨髓涂片方法分析骨髓细胞形态，收集骨髓标本做流式细胞术分析，24 h培养R显带做常规核型分析。该病例骨髓细胞形态学分析显示大而突出的胞核，染色体分析显示近四倍体核型，结合骨髓形态和免疫分型结果诊断为AML-M4。患儿经过4个疗程的化疗治疗，最终获得了临床缓解, 但该患儿达到缓解的时间比正常核型患儿要长。我们认为近四倍体核型是影响儿童AML治疗与预后的重要因素。［中国当代儿科杂志，2009，11（4）：263-266］

Abstract:

Near-tetraploidy is a rare cytogenetic abnormality in myelocytic malignancies in children, and its significance is unknown. To investigate the characteristics of near-tetraploidy in a child with acute myelogenous leukemia (AML-M4), bone marrow smears were prepared for morphological analysis. Bone marrow samples were collected for flow cytometry, and prepared by short-term (24 hrs) unstimulated culture and R-banding for conventional cytogenetic assay. In this case, the morphological analysis of bone marrow cells showed large and prominent nuclei. The chromosomal analysis (R-banding) demonstrated a near-tetraploidy. Combined with morphological and immunophenotypic results, AML-M4 was confirmed. The patient was given four cycles of chemotherapy, and finally achieved clinical remission. However, the duration achieving the remission in the child was longer than AML children with normal karyotype. It is believed that near-tetraploid karyotype may have a great significance to the therapy and prognosis.［Chin J Contemp Pediatr, 2009, 11 (4):263-266］