儿童急性淋巴细胞白血病CD34+表达的临床意义

目的 探讨儿童急性淋巴细胞白血病（acute lymphoblastic leukemia，ALL）CD34^＋表达的临床意义。方法 采集54例ALL患儿的骨髓标本，分别进行细胞形态学及细胞化学染色。确定其FAB类型，运用一组相关的单克隆抗体，采用流式细胞仪及直接免疫荧光标记技术进行免疫学检查，采用吉姆萨G显带技术进行核型分析。结果 儿童ALL CD34^＋表达59．26％（32／54）。CD34^＋表达与ALL免疫分型无关，临床上与初诊时的WBC，Hb，PLT无关，而与肝、脾或淋巴结肿大等髓外浸润有关。细胞遗传学异常患儿CD34^＋表达发生率较高。但CD34^＋与CD34^- ALL患儿CR率差异无统计学意义（X^2=0．982，P=0．396）。结论 采用强烈的化疗方案治疗ALL，CD34^＋表达对化疗的临床疗效无明显影响。

Clinical study of CD34+ expression in childhood acute lymphoblastic leukemia

Objective To explore CD34+ expression in childhood acute lymphoblastic leukemia (ALL) and its clinical implication. Methods Immunophenotype analysis was performed on bone marrow aspirates from 54 patients diagnosed as ALL by the French, American and British (FAB) criteria using a comprehensive panel of monoclonal antibodies to lymphoid and myeloid associated antigens. Results Expression of CD34 antigen was found in 32 out of 54 ALL children (59. 26%). And it was close relation with metastasis outside bone marrow, such as hepatosplenomegaly and swelling of lymph nodes (X2 = 6. 102,P = 0. 021), but not with white blood cell (WBC) count, hemoglobin level and platelet count(P> 0.05). Though most ALL patients with CD34+ expression had cytogenetic abnormity, complete remission (CR) rate was no difference between ALL patients with CD34+ expression and those without. Conclusion CD34 antigen expression was detected in a lot of ALL patients, but it was not associated with progression of childhood ALL as a result of intensive chemotherapy carried out.