10例慢性淋巴细胞白血病免疫表型分析

目的：探讨慢性淋巴细胞白血病（CLL）的免疫分型。方法：应用流式细胞仪对10例CLL患者外周血进行淋巴细胞表面抗原检测。结果：10例CLL患者CD19抗原阳性表达率为100%。其中1例患者CD5、CD19、CD20、HLA-DR、CD3、CD13均阳性,且CD34表达率大于10%;另有1例为CD5、CD19、CD20、HLA-DR阳性且伴CD7阳性。CD5、CD19、CD20、HLA-DR同时阳性的患者为50%。结论：CLL以B细胞慢淋为主,免疫分型对慢淋的诊断及鉴别诊断具有重要意义,其免疫分型可存在伴系表达。     

103例慢性淋巴细胞白血病患者免疫表型的研究

目的:探讨慢性淋巴细胞白血病(CLL)的免疫表型特征。方法:采用CD45/SSC双参数散点图设门,应用三色流式细胞术对103例初诊CLL患者骨髓或外周血标本进行免疫分型,另外选择同期5例T淋巴细胞增殖性疾病患者及92例急性淋巴细胞白血病(ALL),其中仅有的5例成熟急性淋巴细胞白血病(Mature-B-ALL)患者作为对照。结果:①103例患者中HLA-DR、CD19、CD20及CD5表达最常见,阳性率依次为100.0%、99.0%、96.0%及78.6%,T相关抗原CD2、CD3、CD4、CD7、CD8及CD25的表达率为3.0%、3.0%、1.9%、2.9%、1.0%和18.6%;5例T淋巴细胞增殖性疾病患者的HLA-DR、CD2和CD5表达阳性率最高,依次为100.0%、80.0%、80.0%,不表达B系相关抗原;CLL及T淋巴细胞增殖性疾病患者无一例表达CD1a、CD14、CD34及CD57;②CLL和T淋巴细胞增殖性疾病患者均伴有髓系抗原表达,CLL中CD13和CD11b的阳性率分别为51.1%和42.9%;T淋巴细胞增殖性疾病患者中CD13和CD11b的阳性率为100.0%和66.7%;③与ALL...     

慢性淋巴细胞白血病的临床免疫表型分析

目的评价慢性B淋巴细胞白血病(B-CLL)患者骨髓或外周血白血病细胞的免疫表型在B-CLL诊断、治疗和预后中的应用价值。方法收集26例B-CLL患者外周血或骨髓标本,应用多参数流式细胞术进行免疫表型测定。结果 26例B-CLL患者外周血淋巴细胞比例明显增加,典型的B-CLL高表达CD19、CD20、HLA-DR、cCD79a、CD5、CD23,而CD3、CD4、CD8、CD2各项指标均极度减低。结论测定B-CLL患者外周血或骨髓白血病细胞的免疫表型对于B-CLL的诊断及预后评价有重要意义。     

慢性淋巴细胞白血病患者31例免疫表型分析

目的 探讨慢性淋巴细胞白血病(CLL)患者细胞免疫表型分型及临床意义.方法 应用流式细胞仪对31例CLL患者淋巴细胞抗原进行免疫分型分析.结果 31例患者CD19全部阳性,HLA-DR阳性率为96.8%,CD5、CD23、CD20、CD22、CD38、CD10阳性率分别为90.3%、90.3%、83.9%、54.8%、32.3%、0.0%,FMC7阳性率为6.5%. 结论 对CLL患者进行免疫表型分析,有重要诊断意义,可以检测CLL患者早期单克隆B淋巴细胞,对患者进行早期诊断、早期治疗.     

50例慢性淋巴细胞白血病患者临床分期和免疫表型的研究

目的探讨慢性淋巴细胞白血病的免疫表型,临床分期以及它们之间的相互关系。方法采用CD45／SSC双参数散点图设门,应用三色流式细胞术对50例慢性淋巴细胞白血病的骨髓或外周血标本进行免疫分型,并根据临床资料进行临床分期。结果50例中绝大部分慢性淋巴细胞白血病患者表达CD19及CD20阳性率分别为96％和98．0％,T系相关抗原CD,阳性率为71．3％,HLA-DR的阳性率为100％;CD38的表达与临床分期存在显著的统计学差异（P〈0．05）。FMC-7与CD30共表达（P〈0．05）。35例随访病人中,14例死亡。死亡患者与存活患者CD23表达与否存在明显差异（P〈0．05）。结论Binet分期比Rai分期简便易行。CD5,CD19,CD20是B-慢性淋巴细胞白血病特异的免疫表型,CD5、FMC-7、CD13作为预后标志缺乏特异性,CD23和CD38可作为评价病人预后的指标。     

大颗粒淋巴细胞白血病

大颗粒淋巴细胞白血病南京大学医学院附属鼓楼医院血液科臧秦川１９７７年Ｍｃｋｅｍａ等首次报道一组与慢性中性粒细胞减少有联系的综合征。当时称Ｔｒ细胞增生综合征（ＴｇａｍａＬｙｍｐｈａｃｇｔｏｓｉｓＳｙｎｄｒｏｍｅｓ，ＴＧＬＳ）。该综合征以大颗粒淋巴细胞（...     

NK细胞型大颗粒淋巴细胞白血病1例临床观察并文献复习

目的　提高对自然杀伤 (NK)细胞型大颗粒淋巴细胞 (LGL)白血病 (NK LGLL)的认识。方法　观察 1例罕见的NK LGLL病例的全过程 ,并进行文献复习。结果　NK LGLL是CD3(- )LGL克隆性增殖性疾病 ,临床以LGL增多、中性粒细胞减少、多器官浸润、肝功能异常和全身症状为特征。NK LGL表达CD2 、CD1 6 、CD56 ,而缺乏CD3、B细胞系、髓细胞系标志 ,无TCR蛋白及基因克隆性重排 ,具有杀伤活性。结论　本病进展快、疗效差 ,生存期短 ,预后不良     

大颗粒T淋巴细胞白血病相关肾损伤一例

患者,男,63岁,因"发热4周、下肢水肿伴尿量减少23天"于2019年4月24日来我院就诊.患者4周前无明显诱因出现发热,体温最高达38. 2℃,伴咳嗽、少量白痰,血常规检查结果示淋巴细胞计数5. 7 × 109/L(1. 1～3. 2 × 109/L,括号内为正常值参考范围,以下相同) , WBC 计数、Hb 及 P...     

T细胞大颗粒淋巴细胞白血病伴纯红细胞再生障碍性贫血1例

大颗粒淋巴细胞(LGL)是淋巴细胞的一种亚群。正常情况下,LGL占外周血单个核细胞的10%～15%。根据功能和免疫表型,LGL可分为:①CD3+LGL,代表活化的细胞毒T淋巴细胞;②CD3-LGL,代表自然杀伤细胞。而大颗粒淋巴细胞白血病(large granular lymphocytic leukemia,LGLL)就是起源于这两类细胞的克隆性疾病。临床分为T细胞型LGLL和NK细胞型LGLL,无论T细胞或NK细胞亚型临床上均可表现为惰     

CD20- and CD56-Positive T-Cell Large Granular Lymphocyte Leukemia in a Human T-Cell Leukemia Virus Type 1 Carrier

A 60-year-old man was diagnosed with asymptomatic T-cell granular lymphocyte (T-LGL) leukemia in September 2006. He was serologically positive for human T-cell leukemia virus type 1 (HTLV-1). However, monoclonal integration of the HTLV-1 genome was not detected in the peripheral blood, suggesting that HTLV-1 did not contribute to the pathogenesis of T-LGL leukemia in the present case. Phenotypically, neoplastic cells of our case were CD3+, CD4*, CD8+, CD16-, CD56+, CD57*, and T-cell receptor (TCR) alphabeta+. They also coexpressed CD20 antigen with weak intensity. This represented a unique case of T-LGL leukemia showing a typical clinical and phenotypic features.     

Dysregulation of CD95/CD95 Ligand-Apoptotic Pathway in CD3+ Large Granular Lymphocyte Leukemia

CD95 (Fas)-induced apoptosis plays a critical role in theelimination of activated lymphocytes and induction of peripheral tolerance. Defects in CD95/CD95L (Fas-Ligand)-apoptotic pathway have been recognized in autoimmune lymphoproliferative diseases (ALPS)and lpr or gld mice and attributed to CD95 and CD95Lgene mutations, respectively. Large granular lymphocyte (LGL) leukemia is a chronic disease characterized by a proliferation ofantigen-activated cytotoxic T lymphocytes. Autoimmune features such ashypergammaglobulinemia, rheumatoid factor, and circulating immunecomplexes are common features in LGL leukemia and ALPS. Therefore, wehypothesize that expansion of leukemic LGL may be secondary to adefective CD95 apoptotic pathway. In this study, we investigatedexpression of CD95 and CD95L in 11 patients with CD3⁺ LGLleukemia and explored the apoptotic response to agonistic CD95monoclonal antibody (MoAb). We found that leukemic LGL from eachpatient expressed constitutively high levels of CD95/CD95L, similar tothose seen in normal activated T cells. However, cells from 9 of these11 patients were totally resistant to anti-CD95-induced apoptosis.Similarly, cells were resistant to anti-CD3-MoAb-triggered cell death.Lack of anti-CD95-induced apoptosis was not due to mutations in theCD95 antigen. Leukemic LGL were not intrinsically resistant toCD95-dependent death, because LGL from all but 1 patient underwentapoptosis after phytohemagglutinin/interleukin-2 activation. Thepatient whose leukemic LGL were intrinsically resistant to CD95 had anaggressive form of LGL leukemia that was resistant to combinationchemotherapy. These findings that leukemic LGL are resistant toCD95-dependent apoptosis despite expressing high levels of CD95 aresimilar to observations made in CD95L transgenic mice. These datasuggest that LGL leukemia may be a useful model of dysregulatedapoptosis causing human malignancy and autoimmune disease.     

微分化型急性髓系白血病5例临床分析

目的：探讨流式细胞免疫分型在微分化型急性髓系白血病（AML-M0）诊断中的作用。方法：分析5例AML-M0患者的临床资料,观察其骨髓细胞形态学和细胞化学染色的特征以及与流式细胞仪骨髓细胞免疫分型的符合程度。结果：5例患者骨髓细胞学均报告原始及幼稚淋巴细胞增多,POX染色阴性,PAS染色部分阳性,流式细胞免疫分型髓系标志CD13、CD33、CD117至少1项阳性,而淋巴系统及巨核细胞系统抗原阴性。结论：骨髓细胞形态学、细胞化学染色结合骨髓细胞免疫表型和细胞遗传学检查是诊断AML-M0的主要依据,其中原始细胞的免疫分型对诊断AML-M0是非常必要的。     

急性有机磷中毒中间综合征24例临床分析

我院1999年7月～2005年12月年共收治急性有机磷农药中毒(AOP)187例,其中24例出现中间综合征(I MS),现报道救治体会。资料与方法一般资料24例I MS患者(男4,女20),年龄17～70岁,平均年龄31.5岁,均为口服有机磷农药中毒。服毒剂量约20～250ml,平均60ml。乐果中毒9例,氧化乐果中毒5例,甲胺磷中毒6例,对硫磷及甲基对硫磷中毒各1例,敌敌畏中毒1例,混合类1例。服毒至入院时间1～28h,其中外院转入16例,转入前已出现I MS4例。I MS诊断标准①有明确的有机磷农药中毒史;②有机磷农药中毒者经治疗胆碱能危象基本消失,神志清醒后7d内出现不同程度的…     

Immunophenotypes and Outcome of Philadelphia Chromosome-Positive and -Negative Thai Adult Acute Lymphoblastic Leukemia

Little evidence exists in Asian countries regarding the incidence, immunologic characteristics, and clinical outcomes of adult patients with Philadelphia chromosome-positive (Ph+) and -negative (Ph-) acute lymphoblastic leukemia (ALL). In this study, we prospectively studied 324 Thai adult acute leukemia patients, 79 (24%) of whom were identified as having ALL. Immunophenotyping was performed by 5-parameter flow cytometry, and karyotyping was conducted by standard banding methods. The Ph chromosome was detected in 18.5% of cases. The mean age of Ph+ ALL patients was 29 years (50% male), and that of Ph- ALL patients was 33 years (62% female). The Ph+ ALL patients had significantly higher white blood cell (WBC) counts (mean, 93 x 10(9)/L), with 67% having WBC counts higher than 50 x 10(9)/L. In contrast, most Ph- ALL patients had WBC counts lower than 50 x 10(9)/L (mean, 36 x 10(9)/L; P < .05). CD10 and CD34 were more highly expressed in the Ph+ ALL patients (mean expression, 83% and 87%, respectively) than in the Ph- ALL patients (45% and 57%; P < .005). The aberrant expression of myeloid antigens, including CD33 and CD13, was also significantly observed in the Ph+ ALL patients. The median survival time of Ph+ ALL patients was 8 months, compared with 22 months for the Ph- ALL patients. In conclusion, immunophenotyping results showed that Ph+ ALL in Thai adults arises from B-cells at an earlier stage of development. Extreme leukocytosis, a younger age, male sex, high expression levels of CD10 and CD34, aberrant myeloid antigens, and poorer rates of survival appeared to be associated with the Ph chromosome in Thai adult ALL cases. The incidence of the Ph chromosome among Thai adult ALL patients was not different from that found in Western countries.     

毛细胞白血病外周血淋巴细胞亚群和NK细胞活性的初步观察

用一组抗Ｔ、Ｂ细胞分化抗原的单克隆抗体检测５例毛细胞白血病病人外周血单个核细胞的表面标记。其中３例Ｂ淋巴细胞占优势（ＣＤ２０：５８％、５０％、６７％；ＣＤ２２：４８％、４３％、５０％，ＳｍＩｇ：８０％、４７％、６０％），包括１例伴有ＩｇＭ单珠峰的病人；２例Ｂ细胞表面标记阳性率很低（ＣＤ２０：２０％，１７％；ＣＤ２２；１５％；１０％；ＳｍＩｇ：１７％、１８％）。５例病人外周血ＷＴ３＋、ＷＴ４＋细胞及ＷＴ４／ＷＴ８比值明显低于正常对照组（Ｐ＜０．００１），ＷＴ８＋细胞增高与正常组比较差异无显著意义（Ｐ＞０．０５）。４例病人ＮＫ细胞活性降低，脾切除后的ＮＫ细胞活性明显升高。     

存活3年以上的急性白血病24例分析

本文报告我院存活3年以上急性白血病24例(急淋与急非淋各12例),存活最长者17年。急白获得长生存期的关键在于确诊后立即给予强有力的联合化疗,争取短期内达CR,之后坚持巩固治疗和缓解后的治疗,加强支持疗法等,可使病人延长生存期,甚至治愈。     

35例老年急性白血病的临床分析

我院2001年-2006年收治35例老年急性白血病患者,现进行回顾性分析如下。 临床资料 一般资料35例（男34,女1）,年龄60-80岁,平均年龄（70．3±9．7）岁。其中急性非淋巴细胞性白血病（ANLL）27例（M1 1例,M2 13例,M3 3例,M4 1例,M5 7例,M6 2例）;急性淋巴细胞性白血病（ALL）8例（L1 1例,L2 4例,L3 3例）,均符合急性白血病诊断及分类标型。