【摘要】 目的探讨Ph染色体阳性急性淋巴细胞白血病(Ph+ALL)与慢性粒细胞白血病急淋变的临床特点。方法对21例Ph+ALL患者及31例慢粒急淋变患者的临床资料进行回顾性对比分析。结果 Ph+ALL与慢粒急淋变有以下区别:①慢粒急淋变肝脾肿大发生率(80.65%)比Ph+ALL(14.28%)高(P<0.05);②起病时慢粒急淋变外周血白细胞数比Ph+ALL高(P<0.05);③Ph+ALL完全缓解率(76.19%)比慢粒急淋变(48.39%)高(P<0.05)。Ph+ALL的中位生存期为(10.76±6.91)个月,而慢粒急淋变的中位生存期为(7.06±6.03)个月,差异有统计学意义(P<0.05)。慢粒急淋变者完全缓解后Ph染色体持续存在,Ph+ALL患者完全缓解后Ph染色体消失。两组患者年龄、性别、骨髓中原始加幼稚细胞数差异均无统计学意义(P>0.05)。结论 Ph+ALL与慢粒急淋变具有不同的临床特点及治疗反应。更多还原

【Abstract】 Objective To explore the clinical features of patients with Philadelphia chromosome-positive acute lymphoblastic leukemia(Ph+ALL) and with chronic myeloid leukemia in lymphoid blast crisis(CML LBC).Methods Retrospective analysis of the clinical data of 21 cases of Ph+ALL and 31 cases of CML LBC.Results Comparing with Ph+ALL patients,CML LBC patients showed following clinical features: ① The incidence of splenomegaly and hepatomegaly(80.65%)was higher than that of Ph+ALL(14.28%)(P<0.05).② The white blood cell count was higher than that of Ph+ALL(P<0.05).③ The complete remission rate(CR)(48.39%) was lower than that of Ph+ALL(76.19%)(P<0.05).The median survival time of patients with Ph+ALL was(10.76±6.91) months,which was significantly longer than that of CML LBC(7.06±6.03)months,(P<0.05).Philadelphia chromosome was still present in bone marrow cells after patients with CML LBC reached complete remission,but it was negative in patients with Ph+ALL.There was no significant differences between the two groups with regard to age,sex,the bone marrow progenitor cells and immature cells(P>0.05).Conclusions Paitents with Ph+ALL and CML LBC present with different clinical features and therapeutic response.更多还原