摘要
目的探讨骨髓增生异常综合征（ＭＤＳ）中的难治性贫血（ＲＡ）亚型和白血病前期（白前）的关系。方法对８６例ＲＡ和６例不符合ＲＡ诊断标准的白前病例进行回顾性分析。结果将３４例（３９．５３％）转化为急性白血病（ＡＬ）、原始细胞增多的ＲＡ（ＲＡＥＢ）和转变中的ＲＡＥＢ（ＲＡＥＢｔ）者定为转化组，其余５２例为未转化组。与未转化组比较，转化组有下列血液学特征：①外周血中、晚幼粒细胞，有核红细胞和巨大红细胞出现频率较高，中性粒细胞明显核左移；②骨髓原始和早幼阶段的粒系和红系细胞比例较高，三系常同时有血细胞发育异常的形态改变，３核以上红细胞、假性ＰｅｌｇｅｒＨｕｅｔ异常及淋巴样小巨核细胞出现率亦较高。结论按现行ＲＡ标准诊断的病例与白前有较大重叠，上述转化组的血液学特征对ＲＡ向ＡＬ转化可能有一定预示作用。根据结果，提出一个预测ＲＡ转化的积分系统。
Objective To investigate
the relationship between MDS RA (refractory anemia subtype of myelodysplastic syndromes)
and preleukemia (PL). Methods Hematological parameters of 86 RA and 6 PL patients were
retrospectively analyzed. Results Thirty four RA cases (39.53%) transformed into acute
leukemia (AL), RA with excess blasts (RAEB), or RAEB in transformation (RAEB t). As compared
with 52 non transformed RA cases , the transformed cases showed the following hematological
features: ①higher frequencies of immature granulocytes (P<0.005),erythroblasts (P<0.05) and
megaloerythrocytes (P<0 05), and higher granulocyte nuclear lobulation (P<0.001) in peripheral
blood; ②higher percentages of early erythroid and granulocytic lineages (P<0.05), and higher
frequencies of erythroblasts with multiple nuclei (P<0.05),pseudo Pelger Huet abnormality
(P<0.05),and micromegakaryocytes (P<0.005) in bone marrow. Conclusion There is a higher
overlap between RA and PL; the above hematological features may be useful for predicting the
transformation of RA patients. Based on those findings, a score system for predicting the
transformation of RA was proposed.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
1999年第2期65-68,共4页
Chinese Journal of Hematology
