细胞毒药物对血液肿瘤细胞形态的影响及其临床意义

郑岚; 郑浩; 姚晓玲; 刘桂玲; 钟春生

doi:10.13898/j.cnki.issn.1000-2200.2019.06.018

细胞毒药物对血液肿瘤细胞形态的影响及其临床意义

Effect of the cytotoxic drugs on the morphology of hematologic tumor cells, and its clinical significance

摘要

摘要:
目的观察血液肿瘤病人应用细胞毒药物后其细胞形态学的改变及其临床意义。
方法收集应用细胞毒药物治疗的血液肿瘤病人的骨髓涂片，共58例。对骨髓涂片进行瑞氏染色，低倍镜下观察骨髓片，判断其增生程度，油镜下观察细胞形态学改变及有无异常细胞。
结果58例病人应用细胞毒药物后，52例（89.66%）骨髓细胞中一系或多系细胞形态发生变化，其中红系细胞形态发生改变36例（62.07%），粒系细胞形态发生改变49例（84.48%），巨系细胞形态发生改变22例（37.93%），6例（10.34%）细胞形态学无明显变化。58例中，血液学达完全缓解39例（67.24%），部分缓解12例（20.69%），未缓解7例（12.07%），其中完全缓解和部分缓解的病人细胞形态均可见一系或多系发生改变，未缓解的病人中仅1例检见细胞形态发生变化。
结论血液肿瘤病人应用细胞毒药物后，可通过其对细胞形态的影响和改变，及早发现不良反应，对于血液肿瘤病人制定更科学更有效的治疗方案、提高病人生存质量具有一定临床意义。

Abstract:
ObjectiveTo observe the cytotoxic drugs on the morphology of hematologic tumor cells, and its clinical significance.
MethodsThe bone marrow smears of 58 patients with hematological tumors treated with cytotoxic drugs were collected.Bone marrow smears were stained using Wright's staining, and observed under low power microscopy to judge the degree of proliferation.The morphological changes of cells and abnormal cells were observed under oil microscopy.
ResultsAmong 58 patients treated with cytotoxic drugs, the morphological changes in one or more lines of bone marrow cells in 52 cases(89.66%) were found, which included the morphological changes of erythrocyte in 36 cases(62.07%), the morphological changes of granulocyte in 49 cases(84.48%), the morphological changes of mega-cell in 22 cases(37.93%) and no significant change in 6 cases(10.34%).The results of hematology examination in 58 patients showed that the complete remission in 39 cases(67.24%), partial remission in 12 cases(20.69%) and no remission in 7 cases(12.07%) were identified.The cell morphology changes in one or more lines in patients with complete remission and partial remission were found, and no cell morphology change in 1 case with no remission was detected.
ConclusionsAfter the hematological tumor patients were treated with cytotoxic drugs, the adverse reactions can be detected as early as possible through the effects and changes of cell morphology, which has certain clinical significance in developing more scientific and effective treatment schemes and improving the quality of life in hematological tumor patients.

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