You Position: Home > Paper
CHROMOSOME ABNORMALITIES OF BM CELLS IN MYELODYSPLASTIC SYNDROMES AND THEIR LEUKEMIA DEVELOPMENT
( views:347, downloads:108 )
- Author:
- No author available
- Journal Title:
- JOURNAL OF LEUKEMIA & LYMPHOMA
- Issue:
- 6
- DOI:
- 10.3760/cma.j.issn.1009-9921.2004.06.004
- Key Word:
- MDS;AA;染色体;SCD;V-erbB重排/扩增;发病原理
Abstract： 目的:探讨在骨髓增生异常基础上白血病发展.方法:骨髓细胞Brdu-SCD细胞周期检测法和R-带染色体核型分析法,在1989年-1998年间对361例MDS(按FAB分类)、11例回顾性诊断白血病前期(PL)和73例MDS-RCMD(按WHO分类)以及140例AA和PNH骨髓细胞进行分析.并对18例MDS-RCMD进行V-erbB基因诊断.还对30例MDS和AA进行动态观察.与此同时,有25例MDS转变为急性白血病,它们几乎都是骨髓细胞SCD阴性患者,与回顾性诊断白前的结果相同.结果:1)361例MDS中MDS-RA占91.3%,核型异常检出率为66.2%,SCD阴性病例占50.9%,与以往报道的结果相似.染色体异常检出率高于文献报道.MDS中两项均不正常的病例占31.5%.2)AA和PNH核型异常检出率为13.5%,SCD阴性病例占19.2%.两项指标均明显低于MDS,且两项均不正常患者仅为1.4%.3)MDS,RCMD,AA和回顾性白前有相同染色体异常,但有不同的克隆性异常检出率.4)MDS从SCD阳性转变为阴性,AA保持阳性或阴性转变为阳性.结论:1)白前和MDS发展为白血病,或白前转变为MDS而后发展为白血病的共同机制在于骨髓细胞SCD阴性..它可能与胸苷酸代谢异常和胸苷酸合成酶基因扩增并长期积累有关.2)白前、MDS和AA可能有共同的细胞克隆起源.这一点已为AA/AML家系研究所证实.
- [1]Christine F, Skibola,Martyn T, Smith,Alan, Hubbard,etc.Polymorphisms in the thymidylate synthase and serine hydroxymethyltransferase genes and risk of adult acute lymphocytic leukemia.[J].2002,99(10).
- [2]P, Greenberg,C, Cox,M M, LeBeau,etc.International scoring system for evaluating prognosis in myelodysplastic syndromes.[J].1997,89(6).
- [3]冯宝章,雷健玲,徐丽娟,等.用姐妹染色单体分化（SCD）染色法有可能预测白血病的发生[J].1986,(7).
- [4]Catherine Lucioni,Martine Muleris,Laure Sabatier,etc.Chromosomal and enzymatic patterns provide evidence for two types of human colon cancers with abnormal nucleotide metabolism[J].1988,200(1-2).
- [5]冯宝章,雷健玲,邵宗鸿,等.家族性骨髓细胞非随机染色体丢失与白血病发生[J].1999,(2).
- [6]A, Tichelli,A, Gratwohl,C, Nissen,etc.Late clonal complications in severe aplastic anemia.[J].1994,12.
- [7]L, Kass,D, Munster.Thymidylate synthetase and serine transhydroxymethylase activities in preleukemic disorders of erythropoiesis and acute leukemia.[J].1980,65(2).
- [8]W, Dameshek.Riddle: what do aplastic anemia, paroxysmal nocturnal hemoglobinuria (PNH) and "hypoplastic" leukemia have in common?[J].1967,30.
- [9]冯宝章,雷健玲,王琦,等.急性白血病及其前期与患者（儿）父母关系的遗传学研究[J].1998,(2).
- [10]冯宝章,张国臣.早期红白血病家系的基因诊断和发病机理研究[J].1991,030 (6).
- [11]Najfeld V,Raskind WH,Steinmann L.Clonal development of myeloproliferative disorders: clues to hematopoietic differentiation and multistep pathogenesis of cancer.[J].1998,12(2).
- [12]N S, Young.The problem of clonality in aplastic anemia: Dr Dameshek's riddle, restated.[J].1992,79.
- [13]冯宝章,雷健玲,韩金哲,等.骨髓增生异常综合征和再生障碍性贫血等细胞遗传学研究[J].1994,(11).