慢性淋巴细胞白血病的预后因素

慢性淋巴细胞白血病(CLL)是一种异质性疾患。约95%的患者为B淋巴细胞单克隆增殖,少数患者为T淋巴细胞受累。多发生于50岁以上的老年人,偶见于青年或儿童。男性多于女性。中位生存期5年左右,部分患者在诊断后1年内死亡,而一些患者则生存10年以上。因此,对CLL患者预后因素的鉴别,对预测患者病情的发展、确定治疗方案或观察疗效以及监视疾病是否恶化均有十分重要的意义。近年来,在预测患者预后方面有了重要进展,一些学者     

单一治疗中心慢性淋巴细胞白血病的处理:生存期预后因素的研究

为了进行生存期预后因素的研究,作者回顾分析1966～1990年间巴塞洛缪州医院肿瘤科119例慢性淋巴细胞白血病(CLL),按Rai和Binet分类。治疗指征为出现骨髓衰竭症状(贫血、重度感染和/或血小板减少症状),肝脾淋巴结进行性肿大,淋巴细胞进行性增多或出现体质性症状。57例(48％)就     

慢性淋巴细胞白血病新的预后分类

以往一些文献虽强调了慢性淋巴细胞白血病(CLL)的许多预后因素,如性别、年龄、外周淋巴细胞增多、贫血、血小板减少、皮肤表现、炎症以及并发肉瘤等,但未能确定这些因素中每个表现的重要性。本文通过两组295例 CLL 的分析提出了新的预后分类。第一组 CLL99例,系回顾性研究病例称回顾组,     

慢性淋巴细胞性白血病预后研究进展

慢性淋巴细胞性白血病(CLL)是造血系统的一种单克隆性B淋巴细胞增殖性疾病,其病程差异很大,可以从数月到数十年,一些患者从不需任何治疗,一部分则病情快速进展。因此对于初诊为CLL的患者,首要问题不是选择治疗方案,而是考虑何时开始治疗。临床医师需要面对问题是:那些早期患者需要治疗?那些患者应该接受更为积极的治疗?那些患者应该进行骨髓移植?要回答这些问题,有赖于对每一个患者进行准确的预后估计。目前临床上广泛采用Rai和Binet分期来估计患者的预后。然而根据Rai和Binet分期,在新诊断的CLL中,近90%的患者属于低危和中危组,但它们的预后和对治疗的反应却不一样[1]。即使分期属于高危组的患者,也有一部分在很长时间里并不需要治疗,表现出一个“惰性”的病程。因此临床分期系统不能很好地预测CLL患者在诊断时的临床病程。长期以来,“观察和等待”一直是早期CLL患者的标准治疗策略。随着新的治疗方法的出现,特别是免疫化疗和骨髓移植的广泛应用,早期积极的治疗可能使临床进展迅速、预后差的早期CLL获益。这就需要把能够很好判断患者预后的指标纳入临床实践。近年来,在筛选能够预测CLL患者疾病进展趋势的分子和细胞标记方面取得了很...     

203例慢性淋巴细胞白血病患者预后相关因素分析

目的 探讨慢性淋巴细胞白血病(CLL)患者预后的主要影响因素.方法 回顾性分析2000年至2007年就诊于中国医学科学院血液病医院并获得有效随访的203例CLL患者临床资料,收集可能影响预后的因素,以Kaplan-Meier法绘制生存曲线,用Log-rank检验进行单因素分析,运用COX回归模型评估独立预后因素.结果 全组CLL患者中位随访时间为48.0(3.0～156.0)个月,5年总体生存(OS)率为(87.3±2.4)%,10年OS率为(77.4 ±3.3)%,死亡48例(23.6%).单因素分析显示临床分期为晚期、有B症状、结外器官受累、受累淋巴区≥3个、肝脏肿大、Hb<100 g/L、BPC<100 ×109/L、外周血淋巴细胞计数(ALC)>50 ×109/L、形态学表现为混合细胞型、病程中出现分期进展、对治疗无反应、并发感染、并发第二肿瘤或类型转化为不良预后因素.多因素分析显示受累淋巴区≥3个和彤态学表现为混合细胞型为独立的不良预后因素,根据这两项结果重新分组,低危、中危、高危组患者5年OS率分别为(89.8±3.5)%、(66.4±7.2)%、(15.0±13.8)%.各组间差异均具有统计学意义(P值均<0.05).结论 初诊时受累淋巴区数和CLL细胞形态学特征有助于评估CLL患者的预后.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

203例慢性淋巴细胞白血病患者预后相关因素分析

Objective To explore prognostic factors in patients with chronic lymphocytic leukemia (CLL). Methods Two hundred and three CLL patients in our hospital between 2000 to 2007 were retro-spectively reviewed for prognostic factor analysis. Survival was analysed by Kaplan-Meier analysis, univariate analysis by Log-rank test and multivariate analysis by COX regression model. Results With a median follow-up time of 48.0 (3.0 - 156.0) months, the 5-year overall survival (OS) rate was (87.3 ± 2.4) % and 10-year OS rate was (77.4 ± 3.3) %. Forty-eight (23.6%) patients died. Univariate analysis indicated that ad-vanced clinical stage, B symptoms, extranodal involvement, number of lymph node regions involved ≥3, en-larged liver, Hb < 100 g/L, BPC < 100 × 109/L, absolute lymphocyte count (ALC) > 50 × 109/L, atypical cell morphology, progression to stage, non-respons to treatment, complicating infections and secondary cancer or disease transformation were associated with poor prognosis. And on multivariate analysis, lymph node re-gion involvod≥3 and atypical cell morphology were independent poor prognostic factors. Based on the two in-dependent poor prognostic factors, three risk groups were defined: low- (0 factor), intermediate-(one factor) and high-(two factors) groups. The 5 year OS rates were (89.8 ± 3.5) % , (66.4 ～ 7.2) % and (15.0 ±13.8)%, respectively, and the difference between them was statistically. Conclusion The number of lymph node region involved and cell morphology are useful for assessing CLL patients prognosis.     

额外的12号染色体和慢性淋巴细胞白血病的预后

近来采用B细胞丝裂原如脂多醣(LPS)和EB病毒(EBV)等对慢性淋巴细胞白血病(CLL)患者进行染色体研究,发现约50％的病例有额外的12号染色体(“+12”),但其临床意义远未明了。本研究初步表明“+12”可能意味着预后不佳。作者对22例B细胞CLL的外周血淋巴细胞用LPS和EBV处理,培养5天后按常规收获细胞,制备染色体,结果14例获得成功。Q带分析揭示除3例无异常外,其余11例均有染色体畸变:7例有“+12”,其中,2例“+12”为唯一的异常,5例还合并其它畸变;3例有包括6号染色体缺失在内的复杂畸变,其中1例有一个涉及12和14号染色体的易位;1例有一个涉及11和14号染色体的易位。本组患者经随访5～72个月,9例因病程中出现治疗指征而给于强的松或瘤可宁等治疗(其中属于“+12”组的就有6例),5例病情始终稳定,未予化疗。作者将伴有“+12”组和不伴有“+12”组的临床资料作了     

白血病的检验 慢性淋巴细胞白血病

1概述慢性淋巴细胞白血病（简称CLL）被认为是某些免疫功能不全的淋巴细胞在体内恶性增殖、蓄积所致的疾病。本病多侵犯淋巴结、脾脏、骨髓，除可表现有形态学改变外，常伴有免疫球蛋白的缺陷。根据免疫学技术证实，95％以上的CLL为B淋巴细胞型，极少数为T淋巴细胞型。在我国CLL发病率很低，约占全部白血病的4％以下，占慢性白血病的10％以下，但近年来有增高的趋势。CLL发病年龄90％以上为＞50岁的患者，男女之比约为2：1。＊＊L起病隐袭。进展缓慢，多表现为无痛性、渐进性淋巴结肿大，有的病例以脾肿大为主。其主要病理变化为在淋…     

典型与不典型免疫表型慢性淋巴细胞白血病的预后相关因素分析

Objective To analyze the proguostic factors for chronic lymphocytic leukemia (CLL) with typical and atypical immunophenotype. The parameters analyzed included sex, age, Binet stages, abso-lute lymphocyte count (ALC), immunoglobulin heavy-chain variable region (IgVH) gene mutation status, ZAP-70 protein, CD38 expression and cytogenetic aberrations. Methods According to the clinical guideline and scoring system for CLL in Britain, among 77 patients, 61 patients with score 5 called typical immunophe-notype CLL, 16 with score 4 or 3 were atypical immunophenotype CI,L. Multiparameter flow cytometry was employed for immunophenotypic analysis in 77 CLL patients for CD5, CD19, CD23, FMC7, slg, CD20, CD79h expression and ZAP-70 protein and CD38. IgVH mutation status was detected by multiplex RT-PCR and sequencing of the purified PCR amplification products. Fluorescence in situ hybridization (FISH) and a panel of probes were used to detect cytogenetic aberrations. Results There was no significant difference be-tween the two groups in sex, age, ZAP-70 and IgVH mutation status (P =0.398, P =0. 189, P =0.268 and P =0. 131, respectively). The incidence of ALC≥50 × 109/L, Binet B + C, CD38 ≥30% in atypical CLL patients(43.8%, 87.5% and 43.8%, respectively) were higher than that in typical group (16.4%, 36.1% and 16.4%, respectively) (P = 0. 026, P < 0. 01 and P = 0. 026, respectively). The proportion of typical patients (26. 8%) with a 13q14 deletion as sole abnormality was higher than that of atypical patients (7.6%), and that with deletion of 11q22 or 17p13 was lower than that of atypical patients (12.2% vs 46.2%) (P = 0. 022). Conclusion There were obvious differences between the typical immunophenotype CLL and atypical CLL in ALC, Binet stages, CD38 expression level and cytogenetic aberrations.     

典型与不典型免疫表型慢性淋巴细胞白血病的预后相关因素分析

Objective To analyze the proguostic factors for chronic lymphocytic leukemia (CLL) with typical and atypical immunophenotype. The parameters analyzed included sex, age, Binet stages, abso-lute lymphocyte count (ALC), immunoglobulin heavy-chain variable region (IgVH) gene mutation status, ZAP-70 protein, CD38 expression and cytogenetic aberrations. Methods According to the clinical guideline and scoring system for CLL in Britain, among 77 patients, 61 patients with score 5 called typical immunophe-notype CLL, 16 with score 4 or 3 were atypical immunophenotype CI,L. Multiparameter flow cytometry was employed for immunophenotypic analysis in 77 CLL patients for CD5, CD19, CD23, FMC7, slg, CD20, CD79h expression and ZAP-70 protein and CD38. IgVH mutation status was detected by multiplex RT-PCR and sequencing of the purified PCR amplification products. Fluorescence in situ hybridization (FISH) and a panel of probes were used to detect cytogenetic aberrations. Results There was no significant difference be-tween the two groups in sex, age, ZAP-70 and IgVH mutation status (P =0.398, P =0. 189, P =0.268 and P =0. 131, respectively). The incidence of ALC≥50 × 109/L, Binet B + C, CD38 ≥30% in atypical CLL patients(43.8%, 87.5% and 43.8%, respectively) were higher than that in typical group (16.4%, 36.1% and 16.4%, respectively) (P = 0. 026, P < 0. 01 and P = 0. 026, respectively). The proportion of typical patients (26. 8%) with a 13q14 deletion as sole abnormality was higher than that of atypical patients (7.6%), and that with deletion of 11q22 or 17p13 was lower than that of atypical patients (12.2% vs 46.2%) (P = 0. 022). Conclusion There were obvious differences between the typical immunophenotype CLL and atypical CLL in ALC, Binet stages, CD38 expression level and cytogenetic aberrations.     

典型与不典型免疫表型慢性淋巴细胞白血病的预后相关因素分析

Objective To analyze the proguostic factors for chronic lymphocytic leukemia (CLL) with typical and atypical immunophenotype. The parameters analyzed included sex, age, Binet stages, abso-lute lymphocyte count (ALC), immunoglobulin heavy-chain variable region (IgVH) gene mutation status, ZAP-70 protein, CD38 expression and cytogenetic aberrations. Methods According to the clinical guideline and scoring system for CLL in Britain, among 77 patients, 61 patients with score 5 called typical immunophe-notype CLL, 16 with score 4 or 3 were atypical immunophenotype CI,L. Multiparameter flow cytometry was employed for immunophenotypic analysis in 77 CLL patients for CD5, CD19, CD23, FMC7, slg, CD20, CD79h expression and ZAP-70 protein and CD38. IgVH mutation status was detected by multiplex RT-PCR and sequencing of the purified PCR amplification products. Fluorescence in situ hybridization (FISH) and a panel of probes were used to detect cytogenetic aberrations. Results There was no significant difference be-tween the two groups in sex, age, ZAP-70 and IgVH mutation status (P =0.398, P =0. 189, P =0.268 and P =0. 131, respectively). The incidence of ALC≥50 × 109/L, Binet B + C, CD38 ≥30% in atypical CLL patients(43.8%, 87.5% and 43.8%, respectively) were higher than that in typical group (16.4%, 36.1% and 16.4%, respectively) (P = 0. 026, P < 0. 01 and P = 0. 026, respectively). The proportion of typical patients (26. 8%) with a 13q14 deletion as sole abnormality was higher than that of atypical patients (7.6%), and that with deletion of 11q22 or 17p13 was lower than that of atypical patients (12.2% vs 46.2%) (P = 0. 022). Conclusion There were obvious differences between the typical immunophenotype CLL and atypical CLL in ALC, Binet stages, CD38 expression level and cytogenetic aberrations.