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目的 探讨造血干细胞移植后白血病细胞遗传学改变和基因表达的情况。方法 用骨髓细胞短期培养法和直接法G显带分析染色体;双色荧光原位杂交检测bcr/abl融合基因。结果 2例供者为女性的男性急性髓细胞性白血病患者allo PBSCT后,染色体检测持续46,XX。最长生存已50个月。4例慢性髓细胞性白血病经allo PBSCT后,Ph染色体阳性和bcr/abl融合基因阳性1例,供者淋巴细胞输注加干扰素治疗,已生存70个月。Ph染色体阴性bcr/abl融合基因阳性2例,最长生存已27个月。Ph染色体阴性bcr/abl融合基因阴性1例,已生存14个月。2例急性髓细胞性白血病自体造血干细胞移植后检测出非特征性染色体畸变,复发后再化疗达完全缓解,最长生存期达81个月。结论 造血干细胞移植后白血病细胞遗传学检测可观察近期疗效,并指导后续治疗方法的选择。
Objective To investigate the cytogenetic changes and gene expression of leukemia after hematopoietic stem cell transplantation. Methods The chromosomes were analyzed by short-term culture of bone marrow cells and direct G-banding. The bcr / abl fusion gene was detected by two-color fluorescence in situ hybridization. Results After 2 weeks of allo PBSCT in 2 male donor patients with acute myelogenous leukemia, the chromosome detection lasted 46 and XX. The longest survival has been 50 months. Four cases of chronic myelogenous leukemia allo PBSCT, Ph chromosome positive and bcr / abl fusion gene positive in 1 cases, donor lymphocyte infusion plus interferon treatment, has survived for 70 months. Ph chromosome negative bcr / abl fusion gene positive in 2 cases, the longest survival has been 27 months. Ph chromosome negative bcr / abl fusion gene negative in 1 case, has survived 14 months. 2 cases of acute myelogenous leukemia autologous hematopoietic stem cell transplantation detected non-characteristic chromosomal aberrations, relapse after chemotherapy and complete remission, the longest survival period of 81 months. Conclusion Leukemia cytogenetic detection after hematopoietic stem cell transplantation can observe the short-term efficacy, and guide the choice of follow-up treatment.