KORELACIJA CITOGENETIKE I STEPENA FIBROZE KOSTNE SRŽI U PRIMARNOJ MIJELOFIBROZI

Vesna Đorđević; Maja Peruničić-Jovanović; Dijana Šefer; Sandra Bižić-Radulović; Ivan Soldatović; Milena Todorović Balint

doi:10.5937/smclk6-57050

Vesna Đorđević Univerzitetski klinički centar Srbije, Klinika za hematologiju, Beograd, Srbija
Maja Peruničić-Jovanović Univerzitetski klinički centar Srbije, Služba za patohistologiju, Beograd, Srbija
Dijana Šefer Univerzitetski klinički centar Srbije, Klinika za hematologiju, Beograd, Srbija
Sandra Bižić-Radulović Univerzitetski klinički centar Srbije, Klinika za hematologiju, Beograd, Srbija
Ivan Soldatović Univerzitet u Beogradu, Medicinski fakultet, Institut za medicinsku statistiku i informatiku, Beograd, Srbija
Milena Todorović Balint Univerzitetski klinički centar Srbije, Klinika za hematologiju; Univerzitet u Beogradu, Medicinski fakultet, Beograd, Srbija

DOI: https://doi.org/10.5937/smclk6-57050

Ključne reči: primarna mijelofibroza, kariotip, biopsija koštane srži

Sažetak

Uvod/Cilj: Primarna mijelofibroza je klonska mijeloproliferativna neoplazma koju karakterišu fibroza kostne srži i ekstramedularna hematopoeza. Fibroza često otežava aspiraciju i biopsiju kostne srži, što takođe otežava i dijagnozu bolesti. Uprkos tome, citogenetska analiza je moguća iz aspirata kostne srži ili iz periferne krvi. Kariotip je nezavisan prognostički parametar u primarnoj mijelofibrozi. Prognostički značaj stepena fibroze kostne srži u primarnoj mijelofibrozi je još uvek diskutabilan. Cilj studije bio je ispitati značaj fibroze kostne srži na ukupno preživljavanje pacijenata sa primarnom mijelofibrozom, kao i korelaciju kariotipa i stepena fibroze kostne srži ovih pacijenata.

Materijal i metode: Ispitivanje korelacije kariotipa i stepena fibroze kostne srži obuhvatilo je 120 od ukupno 136 pacijenata sa primarnom mijelofibrozom. Koristili smo stratifikaciju hromozomskih abnormalnosti prema preporukama prognostičkih skoring sistema: Lille, Mayo, Internacionalnog i Dinamičkog internacionalnog. Analiza kariotipa vršena je konvencionalnom citogenetskom metodom. Biopsije koštne srži pacijenata obojene su metodom Gordon Sweet.

Rezultati: Kod 136 pacijenata sa primarnom mijelofibrozom nije registrovana statistički značajna razlika (p = 0,084) u preživljavanju, bez obzira na stepen fibroze kostne srži. Takođe, nije registrovana korelacija između kariotipa ili hromozomskih aberacija različitog stepena rizika sa stepenom fibroze kostne srži (Lille p = 0,293; Mayo p = 0,108); Internacionalni prognostički skoring sistem p = 0,086; Dinamički internacionalni prognozni skoring sistem (p = 0,613) kod 120 pacijenata sa primarnom mijelofibrozom.

Zaključak: Iako nismo konstatovali korelaciju kariotipa i stepena fibroze kostne srži, smatramo da oba parametra treba da budu zastupljena u nekim od novih Prognoznih Skoring Sistema za primarnu mijelofibrozu.

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