小儿CD_7抗原阳性急性髓系白血病55例临床研究

目的 　研究小儿CD7抗原阳性急性髓系白血病 (CD7+AML)的临床生物学特征及治疗效果。方法 　对 55例初治小儿AML进行细胞形态学、免疫表型、多药耐药P糖蛋白 (P1 70 )检测 ,临床观察 ,并常规采用HAE方案诱导治疗 ,判定疗效。结果2 3例CD7+小儿AML在FAB分型中以M2 、M5 多见。M3 中无一例CD7抗原表达 ,将CD7+与CD7-两组小儿AML进行对比 ,CD7+AML具有肝脏明显增大 (P <0 0 0 5) ,外周血白细胞数、原始细胞比例及P -糖蛋白表达增高等特点 (P <0 0 0 5,P <0 0 1及P <0 0 5) ,且年龄偏低 ,中位数年龄 7 6岁 (P <0 0 1 ) ,治疗效果差 ,完全缓解率4 3% ,达首次缓解中位时间为 55 5天。结论 　小儿CD7+AML具有独特的临床生物学特征 ,常表达P -糖蛋白 ,临床症状重 ,治疗效果差 ,完全缓解率低 (P <0 0 5) ,达首次缓解时间长 (P <0 0 5)。

Clinical Study of 55 Patients in CD7 Positive Child Acute Myeloid Leukemia

Objective To study clinical characteristics an d therapeutic effects on CD_7 positive child acute myeloid leukemia(CD_7+AML) .Methods Morphology, immunophenotype, P-glycoprotein were ex amined in 55 previously untreated CD_7+AML patients. Routine chemotherapeutic regimen HAE was used for the treatments.Results 23 cases exp ressed CD_7+, CD_7+AML patients had a significantly higher incidence of pe rip heral leukocytosis(P<0.05) and blasts(P<0.05) lower median age 7.6 ( P<0.01) and hepatomegaly (P<0.005) and FAB M_2?M_5 subtype were ass ociated (without M_3) with P-glycoprotein expression 43% of CD_7+ AML achiev ed complete remission with a median time to CR of 55.5 days. Conclusio ns CD_7+ AML might constitute a distinct biologic and clinical d is ease entity. Patients with CD_7+ AML are usually P-glycoprotein positive. The se patients had a lower CR rate and a shorter remission duration. Our results su ggest that CD_7 expression on AML cells can be regarded as a prognostic risk fa ctor in AML. <