B细胞幼淋巴细胞白血病七例免疫表型分析

目的 探讨B细胞幼淋巴细胞白血病(B-PLL)免疫表型特征.方法 通过多参数流式细胞术检测并回顾性分析7例B-PLL患者免疫表型,包括CD5、CD10、CD19、CD20、CD22、CD23、CD25、CD27、CD38、CD45、CD148、CD200、ZAP-70、FMC-7、κ、λ.结果 所有患者泛B细胞标志CD19、CD20、CD22均为阳性,其中仅有1例CD20呈中等强度表达,其余6例CD20均呈强阳性表达,CD22仅1例表达较弱,其余6例均呈中等强度表达.所有患者CD10均为阴性,4例CD5阳性,6例CD23阳性,2例FMC-7阳性,1例CD38阳性,4例CD200阳性,CD148均为阳性,轻链限制性表达检测中3例κ型,4例λ型.根据Matutes慢性淋巴细胞白血病免疫表型积分系统评分,1分1例,2、3分各3例.结论 B-PLL的诊断需要整合临床表现、外周血细胞形态学、免疫表型、细胞遗传学、分子生物学等结果综合判断,CD148、CD200或许可以成为B-PLL辅助诊断标志,B-PLL的免疫表型分布特征仍需要增加样本量进一步探讨.

Immunophenotypic analysis of 7 patients with B-cell prolymphocytic leukemia

Objective To explore the immunophenotypic characteristics of the B-cell prolymphocytic leukemia (B-PLL).Methods 4-color multiparameter flow cytometry and a panel of monoclonal antibodies were used to detect immunophenotype in 7 cases of B-PLL including CD5,CD10,CD19,CD20,CD22,CD23,CD25,CD27,CD38,CD45,CD148,CD200,ZAP-70,FMC-7,κ and λ.Results Among 7 cases,all expressed pan-B-cell markers CD19,CD20 and CD22.CD20 was bright positive except one case.CD22 expression pattern was similar to CD20,and only one case expressed weakly,others were medium positive.All cases were negative for CD10 while positive for CD148,CD5,CD23,FMC-7,CD38 and CD200 was positive in 4,6,2,1 and 4 cases,respectively.Light chain restriction expression was observed in 3 cases of κ type and 4 cases of λ type.According to Matutes chronic lymphocytic leukemia scoring system,one case was 1-point score,3 cases were 2-point score,and 3 cases were 3-point score.Conclusions The diagnosis of B-PLL needs systemic integration of clinical manifestations,morphology,cytogenetics,molecular biology and other results.CD148 and CD200 may be the novel differential diagnostic markers of B-PLL.It needs a large sample size of B-PLL patients to furtherly explore the characteristics of immunophenotype of B-PLL.