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급성 백혈병에서의 염색체에 관한 연구

Other Titles
 (A) study on the chromosmal abnormalities of acute leukemia 
Authors
 장준 
Issue Date
1985
Description
의학과/석사
Abstract
[한글] 급성 백혈병의 반수에서 염색체 이상이 백혈병 세포에 나타나며, 특정 염색체 이상이 치료반응과 예후를 결정하는 독립인자로 작용하므로 임상적으로 이의 응용이 시도되고 있다. 저자는 1985년 3월부터 1985년 10월까지 연세대학교 의과대학부속 세브란스 병원에 입원하였던 성인 급성 백혈병 환자 중 급성비임파성 백혈병 22예와 급성 임파성 백혈병 6예를 대상으로 골수의 염색체 검사를 시행하고 임상특징을 관찰하여 다음과 같은 결과를 얻었다. 급성 백혈병 28예 중 정상 염색체군이 14예 (50.0%), 비정상 염색체군이 10예 (35.7%), 중기의 염색체를 관찰할 수 없었던 군이 4예 (14.3%)이었다. 중기의 염색체를 관찰할 수 없었던 4예를 제외한 급성 비임파성 백혈병 18예 중 정상염색체군이 11예 (61.1%), 비정상 염색체군이 7예 (38.9%)이었다. 비정상 염색체군에서 G군 8예, E군 7예, C군 6예, D군 1예, F군 1예의 이상과, hypoploidy 4예, pseudodiploidy 4예, hyperploidy 3예 등이 관찰되었다. 급성 임파성 백혈병 6예 중 정상 염색체군과 비정상 염색체군이 각각 3예 (50.0%)이었다. 비정상 염색체군에서 D군 2예, E군 1예, G군 1예의 이상과, hypoploidy 2예, hyperploidy 1예, polyploidy 1예 등이 관찰되었다. 급성 비임파성 백혈병에서 정상 염색체군과 비정상 염색체군 간에 FAB 아형, 연령, 성별, 혈색소치, 혈소판수, 밸혈구수, 말초혈액과 골수의 아세포수, Auer 소체 양성율 등과의 상관관계를 비교 검토하였으나 유의한 차이를 관찰할 수 없었다. 항암 화학요법을 받은 급성 비임파성 백혈병 정상 염색체군 4예 (57.1%), 비정상 염색체군 5예 중 4예(80.0%), 급성 2예(66.7%)에서 완전 관해가 유도되었다. 이상의 결과로 급성 백혈병 환자의 절반에서 집락성 염색체 이상을 발견하였으나 치료반응 및 예후에 있어서 그 의의를 알기서는 보다 적극적인 골수세포 염색체 검사를 시행하여야 할 것으로 사료된다.
[영문] Chromosomal abnormalities are found in about a half of acute leukemia patient. There are specific chromosomal abnormalities which are closely relaxed to the prognosis and the prediction of the response to the therapy. So chromosomal pattern is thought as an independent factor on the survival of acute leukemia patient Many studies have been performed tool the purpose of clinical application of chromosomal pattern of acute leukemia. We have investigated chromosomal pattern of 28 patients of adult acute leukemia who were admitted to Severance hospital from March, 1985 to October, 1985. We have also observed clinical and hematologic characteristics. The results obtained are as follows: 1. In 28 studied cases of acute leukemia, 14 cases had normal chromosmal pattern, 10 cases abnormal chromoosmal patterns and 4 cases no observable metaphase. 2. In 22 cases of acute nonlymphocytic leukemia, 11 cases had normal chromosomal pattern, 7 cases abnormal chromosomal patterns and 4 cases no observable metaphase. 3. In 6 cases of acute lymphocytic leukemia, 3 cases had normal chromosomal pattern and 3 cases abnormal chromosomal patterns. 4. In 7 cases of acute nonlymphocytic leukemia with abnormal chromosome, chromosomal abnormalities were 8 in group G, 7 in group E, 6 in group C, 1 in group D and 1 in group F. Hypoloidy was found in 4 cases, pseudodiploidy in 4 cases and hyperploidy in 3 cases. Abnormalities of chromosome 21 were found in 4 cases. 5. In 3 cases of acute lymphocytic leukemia with abnormal chromosome, chromosomal abnormalities were 2 in group D, 1 in group E and 1 in group G. Hypoploidy was found in 2 cases, hyperploidy in 1 case and polyploidy in 1 case. 6. There were no significant statistical differences between the normal chromosome group and the abnormal chromosome group of acute nonlymphocytic leukemia in clinical and hematologic chracteristics such as FAB subtype, age, sex, hemoglobin, platelet count, leukocyte count, blast percents of peripheral and bone marrow, and presence of Auer rod. 7. In acute nonlymphocytic leukemia treated with anticancer chemotherapy, complete remission was achieved in 4 cases (53.1%) among 7 cases of normal chromosome group and in 4 cases(80.0%) among 5 cases of abnormal chromosome group. 8. In acute lymphocytic leukemia treated with anticancer chemotherapy, complete remisson was achieved in 1 case (33.3%) among 3 cases of normal chromosome group and in 2 cases (66.7%) among 3 cases of abnormal chromosome group. In conclusion we observed clonal chromosomal abnormalities in a half of acute leukemia and it is necessary to do more investigations for correlation of bone marrow chromosome studies with the prediction of therapy response and prognosis.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/116837
Appears in Collections:
2. 학위논문 > 1. College of Medicine (의과대학) > 석사
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