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摘要: 急性髓系白血病的分型历经多年的发展，从单纯的形态学分型，逐步发展为集形态学、免疫学、细胞及分子遗传学、临床特征为一体的分型体系，尤其是以遗传学为驱动，认知出许多疾病类型，并得到临床应用。本文将对急性髓系白血病分型的发展演变进行简要概述。Abstract: The classification of acute myeloid leukemia has been developed for many years, from sole morphological classification to a system that integrates morphology, immunology, cellular and molecular genetics, and clinical features. Especially driven by genetics, many entities have been identified, and adopted in clinical practice. This paper will provide a brief overview of the development and evolution of the classification of acute myeloid leukemia.
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Key words:
- acute myeloid leukemia /
- classification
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表 1 各类型AML的白血病细胞比例
% BM M1 M2 M4 M5 M6 原始细胞比例 占ANC比例 ＞30 ＞30 ＞30 ＞30 ＞或＜30 占NEC比例 90 ＞30 ＞30 ＞80＄ ＞30 红系/ANC比例 ＜50 ＜50 ＜50 ＜50 ＞50 粒系细胞/NEC# ＜10 ＞10 ＞20+ ＜20+ 数量不等 单核细胞/NEC* ＜10 ＜20 ＞20 ＞80＄ 数量不等 #早幼粒及以下阶段粒细胞；*幼稚单核细胞及单核细胞；+包括原始粒细胞；＄M5a主要为原始单核细胞，M5b主要为幼稚、成熟单核细胞。 
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表 2 核型与形态有关联性AML的MIC分型
核型 比例/% FAB分型 MIC分型 t(8；21)(q22；q22) 12 M2 M2/t(8；21) t(15；17)(q22；q12) 10 M3，M3v M3/t(15；17) t/del(11)(q23) 6 M5a(M5，M4) M5a/t(11q) inv/del(16)(q22) 5 M4Eo M4Eo/inv(16) t(9；22)(q34；q11) 3 M1(M2) M1/t(9；22) t(6；9)(p21-22；q34) 1 M2，M4 with basophilia M2/t(6；9) inv(3)(q21；q26) 1 M1(M2，M4，M7) with thrombocytosis M1/inv(3) t(8；16)(p11；p13) ＜0.1 M5b with phagocytosis M5b/t(8；16) t/del(12)9p11-13) ＜0.1 M2 with basophilia M2 Baso/t(12p) +4 ＜0.1 M4(M2) M4/+4
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表 3 核型与形态无关联性AML的MIC分型
核型 比例/% MIC分型 +8 8 M?/+8 -7 4 M?/-7 7q- 3 M/7q- 5q- 3 M?/5q- -Y 1 M?/-Y +21 1 M?/+21 9q- ＜0.1 M?/9q- i(17q) ＜0.1 M?/I(17q) 20q- ＜0.1 M?/20q- +22 ＜0.1 M?/+22
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| 引用本文: |
王建祥. 急性髓系白血病分型的演变[J]. 临床血液学杂志, 2024, 37(3): 147-149. doi: 10.13201/j.issn.1004-2806.2024.03.001
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| Citation: |
WANG Jianxiang. Evolution of classification in acute myeloid leukemia[J]. J Clin Hematol, 2024, 37(3): 147-149. doi: 10.13201/j.issn.1004-2806.2024.03.001
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