Ph染色体阳性成人急性淋巴细胞白血病患者的免疫表型及临床特征

目的研究ｐｈ染色体阳性成人急性淋巴细胞白血病（Ｐｈ＋ＡＬＬ）患者的临床及生物学特征。方法５１例初治Ｐｈ＋ＡＬＬ，进行细胞形态学／细胞化学、细胞遗传学及免疫分型检查。诱导治疗３８例患者，３２例采用ＤＯＰ方案（柔红霉素、长春新碱、泼尼松），６例ＤＯＰ加左旋门冬酰胺酶（ＤＯＰＬ）方案。２例缓解后采用自体骨髓移植（ＡＢＭＴ）。结果５１例Ｐｈ＋ＡＬＬ在同期１５８例ＡＬＬ中占３２．３％。Ｐｈ＋患者年龄较大，外周血白细胞计数及原幼细胞比例高，ＦＡＢ分型以Ｌ２常见，ＣＤ１０、ＣＤ１９高表达，ＣＤ３４阳性率也较高。完全缓解率为４２．１％，达缓解的中位时间５４天，中位缓解期４．５月。２例ＡＢＭＴ者已分别缓解２２及３３个月。结论Ｐｈ＋ＡＬＬ患者年龄较大，以Ｌ２亚型及Ｂ－ＡＬＬ、ＣＤ３４阳性多见，缓解率低，达缓解时间长，缓解期短。

Immunophenotypic and clinical features of Philadelphia chromosome positive adult lymphocytic leukemia.

Objective To sutdy the immunophenotypic and clinical features of Philadelphia chromosome positive adult acute lymphocytic leukemia (Ph ALL). Methods Fifty one previously untreated Ph ALL were included. Morphologic/cytochemistric, cytogenetic and immunophenotypic examinations were performed. Patients received daunorubicin vincristine prednisone (DOP) or DOP asparaginase (DOLP) induction protocols. Two patients received autologous bone marrow transplantation (ABMT) as postremission therapy. Results The 51 patients were among 158 patients with ALL (32.3%). Patients with Ph ALL were older and had a significantly higher incidence of peripheral leukocytosis and blasts, FAB L 2 subtype, B lineage antigens expression and CD 34 positivity. 42.1% of Ph ALL achieved complete remission (CR). Their remission duration was 4.5 months, the median time to CR was 54 days. Two patients receiving ABMT survived in remission 22 and 33 months, respectively.Conclusion Patients with Ph ALL are usually older, have FAB L 2 morphology, and are B lineage antigens, CD 34 positive. These patients had lower CR rate, shorter remission duration, and needed longer time to achieve CR.