Chromosome Analysis And Its Clinical Significance In Patients With Leukemia

Objective:To investigate the features of chromosome and its significance in the diagnosis, treatment and prognosis in patients with leukemia.Methods:Chromosome specimens of bone marrow cells were prepared by short-time culture, karyotyping was performed by Giemsa R-banding,20metaphase mitosis cells were analysed in each patient.240out of378patients were acute leukemia, including122patients with acute mycloid leukemia (M112, M247, M342, M48, M514, M71),116acute lymphoblastic leukemia (L135, L251, L330) and138patients with chronic myeloid leukemia (CP118, AP7, BP13). Investigation was made on the relationship between karyo-type changes and curative effect and prognosis in some patients with specific chromosome changes. Dynamic detection of chromosomal changes was carried out specially in patients with CML treated with imatinib.Reuslts:Abnormal karyotype in309out of378patients (81.75%) were positive, of which the positive ratio of acute leukemia was75.83%(182/240), while the CML was92.03%(127/138). Of the182patients37(20.33%) showed simple number abnormality, mainly in polyploidy and dysploid, such as+4,-7,+8,+11,+13,+21,+22,-Y and so on. Structural abnormalities were found in113out of the182patients (62.08%), mainly showed in special chromosomal rearrangement and correlated with the FAB typing, such as t (8;21)(q22;q22)(most see in AML-M2) and t (15;17)(q22;q12or21)(only see in AML-M3).32out of the182patients (17.58%) displayed complicated abnormality. By following up, the patients with special chromosome change (M2and M3) were sensitive to chemotherapy and with a better prognosis. In the138CML,92.03%of which was Ph chromosome positive (Ph+),90.55%of the Ph+patients were classical Ph chromosome and9.45%were variant rearrangement. Additional chromosome [(+8, 2Ph,+21, i (17q)] were demonstrated in22(17.32%) of Ph+cases, the rate of additional chromosome was6.48%,71.43%,83.33%, respectively. The rate of AP and BP were higher than that of CP (X2=29.67,24.42, P<0.01), there was no difference between AP and BP (X2=1.43,P>0.05). Ph chromosome was not detected in3patients treated with imatinib after3-7months.Conclusion:Chromosomal aberration rate was high in acute leukemia and correlated with the FAB typing. The patients with typical t(8;21) and t(15;17) were sensitive to chemotherapy and had a better prognosis.There was a close relationship between additional chromosome and the course of progress in patient with CML, P h+CML was more sensitive to imatinib. Our study further confirmed that karyotype analysis plays an important role in the diagnosis, treatment and prognosis of leukemia.