ЗНАЧЕННЯ ПОКАЗНИКІВ ЛЕЙКОГРАМИ ДЛЯ ПРОВЕДЕННЯ ЦИТОГЕНЕТИЧНОГО АНАЛІЗУ КРОВІ ПРИ МІЄЛОФІБРОЗІ

Myelofibrosis is a rare almost incurable disease with lesions of blood-forming stem cells. Cytogenetic abnormalities are independent prognostic markers of unfavorable disease course in myelofibrosis. The method of cytogenetic analysis of the peripheral blood with specific stimulator - granulocyte colony-stimulating factor is used to avoid the need of puncture of bone marrow with fibrotic changes. The aim of the study was to find the criteria for obtaining high-quality metaphase chromosomes from peripheral blood for cytogenetic analysis in patients with myelofibrosis. Leukocyte features and the level of mitotic activity were analyzed in cytogenetic samples of blood obtained using the author's method for 45 patients with myelofibrosis. In 73.3% of patients a sufficient number of suitable for analyzing metaphase plates were obtained, and in 26.7% mitotic cell division in preparations for cytogenetic analysis were not found. Mitotic activity was high in 93.3% of patients with the presence of ≥1% blasts or promyelocytes in leukocyte formula. Metaphase chromosomes were obtained only in 50% of patients without these cells, but with the leukocytic shift to the left to myelocytes, metamyelocytes and/or ≥12% of band neutrophils (mitotic index was lower complicating the cytogenetic analysis). In the absence of significant left shift of leukocytes the sufficient number of metaphase plates for cytogenetic analysis was not found in any patient. Therefore, the cytogenetic studies of specifically stimulated peripheral blood instead of bone marrow is appropriate in the presence of blast cells and promyelocytes in leukocyte formula, and has limited use in case of major leukocyte shift to the left without these cells. Normal leukocyte morphology in the patient requires the study of metaphase chromosomes of bone marrow or the use of cytogenetic techniques with fluorescent hybridization.