91例急性白血病FCM免疫分型分析

目的：研究急性白血病免疫分型及临床意义。方法：采用流式细胞术检测91例急性白血病患者免疫分型情况。结果：①80％以上急性非淋巴细胞白血病(ANLL)患者主要表达CD13、CD33。②按免疫表型的特征可将急性白血病分为3类：系列专一性表达；交叉表达；“裸细胞”型。ANLL中，以系列专一性比例最高，交叉表达在ALL中占有一定比例，“裸细胞”型在ANLL和ALL中比例均最少。交叉表达的病例中，CD7^ ANLL患者CR率低于系列专一性表达者。结论：AL免疫分型可出现系列专一性表达；交叉表达；“裸细胞”型3种类型，CD7^ ANLL交叉表达的患者完全缓解率低于系列专一性表达者。     

用免疫学方法分析急性白血病中多系表达

急性白血病 (ＡＬ)免疫分型不但可以识别白血病细胞的系列来源、所处的分化阶段 ,而且对某些抗原表达的亚型与预后关系的判断具有指导意义。多系抗原表达是ＡＬ免疫分型中较少见的类型 ,国内外的报道较少 ,本研究对此类型的表达特征及意义作简要分析 ,以利于今后白血病的诊治。一、资料和方法1.病例来源 :174例ＡＬ患者均符合ＦＡＢ诊断标准 ,全部病例均来自我院门诊及住院患者。急性髓系白血病 (ＡＭＬ)99例中初治 89例 ,非初治 10例 ;急性淋巴细胞白血病 (ＡＬＬ)75例 ,初治 70例 ,非初治 5例。2 .材料 :取肝素抗凝骨髓或外周血 ,标本中原…     

急性髓系白血病分型的演变

急性髓系白血病的分型历经多年的发展,从单纯的形态学分型,逐步发展为集形态学、免疫学、细胞及分子遗传学、临床特征为一体的分型体系,尤其是以遗传学为驱动,认知出许多疾病类型,并得到临床应用。本文将对急性髓系白血病分型的发展演变进行简要概述。     

116例急性髓系白血病免疫表型特点分析

目的探讨免疫表型检测对急性髓系白血病(AML)的诊断、治疗、预后的临床意义。方法回顾性分析已经确诊的116例AML患者的免疫表型结果。免疫表型检测采用流式细胞术对AML患者的骨髓样本进行多种抗原的检测。结果 116例AML白血病患者主要表达CD33(91.4%)、CD13(94%)、CD117(69%)、HLA-DR(70.7%)、CD34(71.6%),M3较少表达CD34及HLA-DR。淋系抗原在AML患者中也有阳性表达,其中CD56、CD7、CD19阳性率最高,分别为17.2%、15.5%、9.5%。伴有CD56、CD7阳性的AML患者CR率低于CD56、CD7阴性的AML患者。结论白血病免疫表型检测对AML分型诊断、预后判断有重要的指导意义。     

淋系分化抗原在急性髓细胞白血病中的表达及其意义

目的 探讨淋系分化抗原在急性髓细胞白血病（ＡＭＬ）的表达及其临床意义。方法 采用ＡＰＡＡＰ法和流式细胞术检测６４例ＡＭＬ的免疫表型。结果 ９例除表达髓系抗原外尚有淋系抗原表达（Ｌｙ＾＋ＡＭＬ）。Ｌｙ＾＋ＡＭＬ组于初诊时肝脾肿大明显,白细胞总数较Ｌｙ＾－ＡＭＬ组高。用标准方案诱导化疗,其中仅１例部分缓解。结论 Ｌｙ＾＋ＡＭＬ细胞对于常规诱导缓解方案不敏感,选择兼顾ＡＬＬ＋ＡＭＬ的方案可提高治疗效果。     

急性淋巴细胞白血病免疫分型的特点及其临床意义

目的:为了探讨急性淋巴细胞白血病(ALL)各亚型免疫分型的特点及其临床意义。方法:采用CD45/SSC双参数散点图设门,应用三色流式细胞术,对81 例ALL的初诊患者骨髓标本进行免疫分型,并对其中45例进行核型分析。结果:①B细胞系列的ALL(B ALL)中CD19表达最常见(阳性率为100%),而T细胞系列的ALL(T ALL)中CD5和CD7表达阳性率最高,均为90%;B -ALL和T- ALL都存在抗原交叉表达的现象;两组患者的完全缓解(CR)率差异无统计学意义(P>0.05);②伴髓系抗原表达的急性淋巴细胞白血病(My+ALL)比较常见,本组达到39.5%,常累及B淋巴系统(占My+ ALL的84.4%);各髓系抗原中以CD13 表达阳性率最高;此类患者的CR率较高,儿童CR率为72.2%,成人为78.6%;③急性杂合性白血病(HAL)的发病率为19.8%,以髓系、B系共同表达者居多;并且CD34表达阳性率较高(81.3%),该类患者CR率较低(儿童和成人分别为50%和40%);④CD34在B ALL,My+ALL和HAL中表达阳性率较高,而T ALL中少见(P<0.05)。结论:免疫分型在诊断特殊类型的ALL(如HAL,My+ALL)中具有显著优势;CD19和CD5诊断B- ALL和T- ALL的灵敏度较好,但特异性不高,存在抗原交叉表达;CD34和髓系抗原的表达与CR率无相关性,但在HAL,CD34的表达与CR率成负相关。     

微量APAAP法与常规APAAP法在急性白血病免疫分型中应用对比

用常规APAAP法进行急性白血病免疫学分型需血量较多,对小儿患者及需反复抽血的成人采血痛苦也大,微量采血法较方便、经济,且可减少采血量。本文就两种方法的染色结果进行了对比研究。1 材料和方法1.1 病例急性淋巴细胞性白血病(ALL)10例,年龄2～60岁,中位年龄6岁。急性非淋巴细胞性白血病(ANLL)10例,年龄3～70岁,中位年龄26岁。以上病例外周血幼稚细胞均高于50%。1.2 器材与试剂微试管,内径5mm,长3～     

老年CD+56急性髓系白血病临床生物学特征

目的 研究CD+56老年急性髓系白血病(AML)的临床生物学意义.方法 对102例初治老年AML进行细胞形态学、免疫表型、多药耐药P糖蛋白(PgP)检测,并常规采用HAE方案诱导治疗,判定疗效.结果 老年急性髓系白血病,CD56阳性率39.22%.CD+56AML在FAB分型中以M2b、M5、M7多见,高白细胞计数(57.03×109/L vs 33.65×109/L,P=0.047),多表达PgP(62.50% vs 40.32%,P=0.042).CD+56AML患者髓外浸润现象明显(62.50% vs 37.09%,P=0.015),尤其是脾脏(42.50% vs 19.35%,P=0.014)显著受累,CD56表达与年龄、性别、血红蛋白含量、血小板计数及外周血幼稚细胞数无关,也不影响CR率(P值分别为0.306,0.840,0.564,0.302,0.686,0.547),但无病生存时间(DFS)(5.75个月 vs 30.00个月,P=0.048)和总生存时间(OS)(5.34个月 vs 22.03个月,P=0.032)较短.结论 CD+56AML具有独特的临床生物学特征,多表达耐药蛋白PgP,生物学侵袭性较强,生存期短,预后较差.建议初诊时监测CD56分子表达以判断预后.     

三色荧光标记抗体在急性白血病免疫分型中的应用

目的：探讨多参数分析流式细胞术白血病免疫分型的方法。方法：用自行设计的七组三色荧光标记抗体组合，共含15种抗体，对200例急性白血病患者骨髓或外周血进行流式细胞术免疫分型。结果：应用本组抗体组合可对T-急性淋巴细胞白血病、B-急性淋巴细胞白血病和急性粒细胞白血病-M1-M7患者作出免疫学诊断，并可诊断形态学难以辨认的及一般免疫分型法较难诊断的单核细胞白血病。结论：三色荧光标记抗体组合可用较少的抗体，特异地对急性白血病各亚型进行多参数免疫表型分析，提高了免疫分型的准确性。     

Acute Myeloid Leukemia with Multilineage Dysplasia in Children

We retrospectively surveyed pediatric acute myeloid leukemia (AML) patients with multilineage dysplasia treated with the AML 99 and the Children's Cancer and Leukemia Study Group (CCLSG) AML 9805 protocols. We found only 9 AML patients (2.6%) with multilineage dysplasia among the 341 patients with newly diagnosed de novo AML. Eight of the 9 patients obtained complete remission (CR) following the intensive AML-oriented treatments. Three of 7 patients who underwent stem cell transplantation were alive in CR for more than 4 years, and the 2 patients treated only with chemotherapy were alive in CR for more than 30 months. We did not identify any particular chromosomal abnormalities or differentiation according to the French-American-British classification in these 9 patients. No reports have described AML with multilineage dysplasia in children, and the incidence of the disease is expected to be very low. We plan to conduct a prospective pathologic review to select cases with this disease entity in the next Japanese Pediatric Leukemia/Lymphoma Study Group (JPLSG) AML-05 protocol.     

Differential WNT Gene Expression in Various Subtypes of Acute Lymphoblastic Leukemia

Background: Dysregulation of WNT signaling has been reported in many malignancies. Objective: This study was conducted to investigate the expression pattern of 14 members of the WNT gene family in different immunophenotypic subtypes of ALL. Methods: Semi-quantitative RT-PCR was performed on samples from 71 ALL patients and 36 age-matched healthy individuals. The ALL patients were categorized into B-ALL (76%), T-ALL (22.6%) and mixed lineage (1.4%) and the B-ALL cases were further classified into pro-B, pre-BI, pre-BII and immature/mature-B based on immuno-phenotypic results. Results: Among the WNT genes, WNT-7B (p=0.026), WNT-9A (p=0.020) and WNT-16B (p=0.023) were significantly over-expressed, whereas WNT-2B (p=0.033), WNT-5A (p=0.016), WNT-7A (p<0.0001) and WNT-10A (p<0.0001) were down-regulated in B-ALL. Among the T-ALL subtype, however, significant down-regulation of WNT-2B, WNT-5B, WNT-7A, WNT-10A and WNT-11 was evident. Comparison between B-ALL subtypes showed significant over-expression of WNT-7B, WNT-9A and WNT-5B in certain subtypes. Conclusion: Our results suggest contribution of the WNT genes in leukemogenesis of ALL.     

Multilineage Involvement of Light Microscopic Myeloperoxidase-Negative Acute Leukemia

We report an instructive case of diffuse large B-cell lymphoma presenting as acute heart failure. A 69-year-old human immunodeficiency virus-negative man was admitted to our hospital for general fatigue. A computed tomographic scan of the chest and abdomen showed pericardial effusion, but there was no evidence of tumor masses, lymph node enlargement, or hepatosplenomegaly. During the chemotherapy, increased lactate dehydrogenase and pleural effusion appeared. The tumor cells in the effusion showed positivity for CD5, CD19, CD20, kappa chain, and Bcl-2 and negativity for CD10 and CD23. The chromosomes showed t(8;14)(q24;q32) with c-myc/immunoglobulin (Ig)H rearrangement, and the MIB-1 index was not high (60%). Neither human herpes virus 8 nor Epstein-Barr virus DNA was detected in the cells by polymerase chain reaction. The response to chemotherapy was very poor, and the patient died 4 months after the diagnosis. A spectrum of the symptoms of CD5+ lymphoma encompasses pericardial effusion and also can accompany c-myc/IgH rearrangement.     

Expression of CD20 in B Cell Precursor Acute Lymphoblastic Leukemia

CD20 is a B cell differentiation antigen with variable expression in B cell precursor acute lymphoblastic leukemia (BCP-ALL). The significance of CD20 expression has been evaluated in BCP-ALL with conflicting results. There is paucity of data regarding CD 20 expression in BCP-ALL in Indian patients. We retrospectively analyzed 100 patients of BCP-ALL for CD20 expression. CD20 positivity was defined as expression of CD20 to be more than or equal to 20 % in the blast population. 62 % patients expressed CD20 while 38 % patients were negative for CD20. The positivity ranged from negative to dim (35.5 % patients), moderately bright (19.3 % patients) to bright (45.2 % patients). Additional prospective studies are needed to determine the optimal use of rituximab in treatment of CD20-positive BCP-ALL.     

急性粒单和急性单核细胞性白血病的临床和细胞表面标记分析

目的：分析ＡＭＬ－Ｍ４、Ｍ５患者的临床和免疫学特征。方法：总结了７５例患者的血液学和临床特征，并用活细胞间接免疫荧光法检测了其中３９例患者的细胞免疫表型，着重分析了ＣＤ７＾＋ＡＭＬ在这二类ＡＭＬ中的发生率、临床特征及预后。结果：这两类白血病的ＨＬＡ－ＤＲ、ＣＤ３８、ＣＤ３４阳性率很高，分别为９１．４３％，８５．１９％和６５．６３％；结论：Ｍ４、Ｍ５这二种亚型有不同于其它ＡＭＬ亚型的临床，血液学和生     

Microfilariae with Acute Myeloid Leukemia: A Common Parasite with Uncommon Association

Presence of microfilariae in bone marrow aspirate is an uncommon finding and its association with leukaemia has rarely been described. We present a case of young female from north India in which bancroftian microfilariae was seen in peripheral blood and bone marrow smears as an incidental finding along with 88 % myeloid blast that were positive on myeloperoxidase stain. There was no associated eosinophilia. She was started on diethylcarbazine for microfilariae, before the start of induction chemotherapy for acute myeloid leukaemia. Presently she is post induction and is doing fine.     

Reticulum Cell Sarcoma Terminating in Acute Leukemia

The records of 113 patients dying at the Francis Delafield Hospital withdocumented reticulum cell sarcoma revealed six cases whose course terminatedin a syndrome resembling acute leukemia. Their course was characterizedby weakness, pallor, petechiae, hemorrhages and hepatosplenomegaly. Theblood showed anemia, leukocytosis (white blood cell count 20,000 to 80,000/cu.mm.) and thrombocytopenia (platelet count [unknown] 100,000/cu.mm.). Differential count in the blood and the bone marrow revealed a high percentage ofimmature cells (35 to 96 per cent). These were identified as reticulum cellsin three patients, as myeloblasts in two and as monocytoid granulocytes in one.In all six patients, this explosive illness terminated in systemic infection orhemorrhage within two months. Therapy with 6-mercaptopurine, adrenalsteroids, or both, gave no benefit.

Submitted on April 2, 1959 Accepted on June 18, 1959