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(1)B-ALL中CD19表达最常见(阳性率为100%),而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率(CR率)并无显著差异(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%)。(4)CD34在B-ALL,My ALL和HAL中表达阳性率较高,而T-ALL中少见(P<0.025)。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。     

209例急性白血病免疫表型差异和特点

[目的]探讨各型成人急性白血病(AL)组免疫表型的差异和特点。[方法]采用CD45/SSC双参数散点图设门方法对209例急性白血病进行三色流式细胞术免疫表型分析。[结果]151例急性髓细胞系白血病(AML)主要表达MPO(96.03%)、CD13(86.75%)、CD33(84.77%)、CD34(55.63%),HLA-DR(49.67%),CD11736.42%。有23.18%的AML患者伴有淋系抗原表达,最常见CD4、CD7。B细胞系急性淋巴细胞白血病(B-ALL)39例,占18.66%,主要表达cCD79α(100%),CD19(87.18%),CD22(82.05%),CD20(15.38%),HLA-DR(100%)。T系ALL12例(5.74%),主要表达cCD3(100%),CD7(91.67%),CD5(75%),HLA-DR(50%)。有28.85%的ALL表达髓系相关抗原,主要是CD13、CD33。[结论]cCD79α、cCD3、MPO为AL的系列特异性标志,对白血病的准确诊断和分型及预后均有重要的指导意义。     

伴髓系抗原表达的儿童急性淋巴细胞白血病免疫分型特点与疗效分析

目的 分析伴髓系抗原表达的儿童急性淋巴细胞白血病 (ALL)的免疫分型特点与临床疗效预后的关系.方法 根据国际白血病欧洲协作组 (EGIL)标准,采用流式细胞术检测白血病细胞的免疫表型,对98例初诊急性淋巴细胞白血病(ALL)儿童分为My- -ALL和My+ -ALL组,My+ -ALL包括My+ B-ALL和My+ T-ALL组,给予正规治疗,对其预后进行观察.结果 My+-ALL患儿25例发生率为25.5%(25/98),其中My+ B-ALL 18例,占72.0%(18/25),My+ T-ALL 7例,占28.0%(7/25).My+ B-ALL和My+ T-ALL患儿中,髓系表达指标CD13阳性率最高,其次为CD33,而CD117均未表达.My+ B-ALL与My- B-ALL、My+ T-ALL与My- T-ALL患儿CR率相比较均无统计学意义 (P＞ 0.05),但在My+ B-ALL组患儿达缓解所需的时间差异存在统计学意义(P＜ 0.05).结论 免疫表型的研究为儿童急性白血病亚型提供了临床诊断的依据.My+ -ALL的预后没有因髓系抗原的表达而与My--ALL表现出明显差异.     

急性淋巴细胞白血病免疫分型的特点及其临床意义(英文)

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 (1)B-ALL 中 CD19表达最常见(阳性率为100%),而 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率(CR 率)并无显著差异(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%)。(4)CD34在 B-ALL,My~+ALL 和 HAL 中表达阳性率较高,而 T-ALL 中少见(P<0.025)。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。     

急性淋巴细胞白血病伴CD13表达免疫表型分析

目的：探讨急性淋巴细胞白血病（acutelymphocytic leukemia,ALL）伴CD13表达的免疫表型特点,对包括CD33在内的其他抗原进行相关性分析.方法：对85例初诊ALL患者进行免疫学分型,以是否表达My把B-ALL和T-ALL分为My＋ALL和My-ALL,进行组间分析.结果：全部85例B-ALL和T-ALL患者均高表达B系和T系相关抗原（100%,100%）.所有的B-ALL均不表达T-ALL相关抗原,所有T-ALL均不表达B-ALL相关抗原.CD13的表达率为31%（B-ALL31.4%,T-ALL 28.6%）.My＋B-ALL和My＋T-ALL患者的CD13阳性细胞的中位数高于My-B-ALL和My-T-ALL患者,P值分别为0.013和0.04.My＋B-ALL患者的CD15阳性细胞的中位数高于My-B-ALL患者,P=0.000 1.结论：白血病免疫分型对于白血病的诊断、治疗和预后判断均有很大帮助,其在临床诊断中的推广将有助于患者的诊断和治疗.CD13在My＋ALL中表达较高（31%）,白血病细胞在恶性演变过程中不同时期表现出特征反映,其临床意义有待于重新评价.     

儿童急性髓系白血病免疫表型特点分析

目的:分析儿童急性髓系白血病(AML)免疫表型特征,探讨其临床意义.方法:采用四色流式细胞术CD45/SSC双参数散点图设门方法,对127例儿童AML患者幼稚细胞进行免疫表型检测,对抗原表达情况进行分析.结果:在127例儿童急性髓系白血病患者中,髓系特异性抗原CD33、CD13和CD117的表达最常见,分别达95.3%、90.6%、90.6%.造血干/祖细胞抗原CD34、HLA-DR、CD38阳性率分别达53.5%、71.6%和97.6%.有65.4%的病例伴有淋系抗原的表达,其中以CD56的表达最常见占38.6%,其次为CD7占21.3%.有淋系抗原表达(LymAg+)患者早期抗原CD34和HLA-DR抗原表达阳性率明显高于无淋系抗原表达(LymAg-)患者(P<0.05).结论:免疫分型对儿童AML的诊断和不同亚型鉴别具有重要意义.     

急性淋巴细胞白血病伴CD13表达免疫表型分析

目的探讨急性淋巴细胞白血病(acutelymphocytic leukemia,ALL)伴CD13表达的免疫表型特点,对包括CD33在内的其他抗原进行相关性分析.方法对85例初诊ALL患者进行免疫学分型,以是否表达My把B-ALL和T-ALL分为My+ALL和My-ALL,进行组间分析.结果全部85例B-ALL和T-ALL患者均高表达B系和T系相关抗原(100%,100%).所有的B-ALL均不表达T-ALL相关抗原,所有T-ALL均不表达B-ALL相关抗原.CD13的表达率为31%(B-ALL31.4%,T-ALL 28.6%).My+B-ALL和My+T-ALL患者的CD13阳性细胞的中位数高于My-B-ALL和My-T-ALL患者,P值分别为0.013和0.04.My+B-ALL患者的CD15阳性细胞的中位数高于My-B-ALL患者,P=0.000 1.结论白血病免疫分型对于白血病的诊断、治疗和预后判断均有很大帮助,其在临床诊断中的推广将有助于患者的诊断和治疗.CD13在My+ALL中表达较高(31%),白血病细胞在恶性演变过程中不同时期表现出特征反映,其临床意义有待于重新评价.     

成人急性淋巴细胞白血病免疫表型及细胞遗传学特征分析

目的：对110例成人急性淋巴细胞白血病（ALL）患者进行免疫表型及细胞遗传学特征分析.方法：采用CD45/SSC参数设门四色流式细胞术检测110例成人ALL患者治疗前骨髓细胞的免疫表型,染色体R显带技术对其中的73 例进行核型分析.结果：110例ALL患者中,21.8%为T-ALL,78.2%为B-ALL.47.3%的ALL患者表达髓系抗原 （MyAg）,CD13是成人ALL中最常见的MyAg （32.1%）.T-ALL髓系相关抗原表达总的阳性率（45.8%）与B-ALL（47.7%）无统计学差异.可供核型分析的73例中核型异常者37例（50.7%）,最常见的遗传学异常为Ph染色体,占23.3%.结论：免疫表型对ALL的诊断与分型至关重要,免疫表型与患者的异常核型改变及临床特征关系密切.     

急性白血病免疫表型分析及其临床意义

 目的 探讨急性白血病（AL）的免疫表型特点及其临床意义。方法 采用间接免疫荧光法检测分析107例AL患者的免疫表型。结果 CD33、CD13是急性髓系白血病（AML）中最有诊断价值的指标,CD14有助于AML-M4、AML-M5与其他亚型的区别。CD2、CD7是T淋巴细胞白血病（T-ALL）中最有诊断价值的指标,CD19、CD22是B淋巴细胞白血病（B-ALL）中最有诊断价值的指标。17例ALL患者伴髓系抗原（My+ALL）表达率为11.76 %,85例AML患者伴淋系抗原（Ly+AML）表达率为24.71 %。My+ALL和My-ALL患者的CR率分别为0和71.43 %,差异无统计学意义（P＞0.05）。Ly+AML和Ly-AML患者的CR率分别为33.33 %和80.95 %,差异有统计学意义（P＜0.01）。CD+34 AML和CD-34 AML患者的CR率分别为40.74 %和83.33 %,差异有统计学意义（P＜0.01）。HLA-DR+AML和HLA-DR-AML的CR率分别为48.15 %和79.63 %,差异有统计学意义（P＜0.01）。结论 免疫表型分析对AL的诊断以及治疗指导、预后判断等均具有重要意义。     

CD45设门多参数流式细胞术在急性白血病免疫表型分析中的应用

目的：分析急性白血病的抗原表达及其临床意义。方法：采用一组系列相关单抗直接免疫荧光标记CD45设门的多参数流式细胞术,检测35例急性白血病患者的免疫表型。结果：11例ALL中B－ALL8例,T－ALL3例,其中出现髓系抗原表达4例,占36．4％,CD34表达10例,占90．1％;24例AML中伴淋系抗原表达7例,占29．17％,CD34表达16例,占70．8％,DR的表达与CD34一致,5例M3患者均无CD34和HLA DR表达。伴髓系统原表达的ALL CR率低于髓系抗原阴性表达者（1／3及5／6）,但统计学上差异无显著性（P＞0．05）;伴淋系抗原表达的AML患者CR率明显低于淋系抗原阴性表达者（0／5及10／10）,两组间差异具有显著性（P＜0．01）。结论：CD45设门的多参数流式细胞术是分析白血病免疫表型的最好方法,白血病抗原的错义表达是预后不良的因素之一。     

The value of the immunological subtypes and individual markers compared to classical parameters in the prognosis of acute lymphoblastic leukemia.

The value of the immunophenotypical subtypes and individual markers was compared with classical parameters in the prognosis of 150 patients with acute lymphoblastic leukemia (ALL). Regarding the immunophenotype, common-ALL had a better prognosis than T-ALL in the children's group. However, in adults the situation was different since both null and T-ALL patients had longer survival rates than the common pre-B group. Moreover, several individual markers add interesting prognostic information, either in ALL as a whole group or within the different immunophenotypes. Thus, the expression of CD10 and TdT had a significantly favourable influence in the outcome of the whole series of patients; within the T-ALL, those cases positive for CD10 also had a longer median survival (33 versus 17 months). In addition, in the common ALL patients group the expression of a relatively mature B marker--CD20--appeared to have a favourable prognosis (27 versus 13 months). Other non lineage specific markers, such as CD9 and CD38 did not seem to influence survival. Regarding the more conventional parameters, our data suggest that the classical age prognostic classification in children (less than 15 years) and adults can be improved using two cut-off points at 11 and 35 years. Moreover, the multivariate analysis showed that this variable, together with FAB morphology and WBC counts were the best combination of parameters for predicting survival. The present study shows that although the immunophenotype helps us in understanding the biological heterogeneity of ALL, having also prognostic implications, there are other clinical and hematological features that yield stronger prognostic information.     

68例成人白血病免疫分型特点分析

[目的]分析68例成人白血病免疫分型特点.[方法]采用单克隆双色或三色直接荧光标记,流式细胞仪检测以CD45-SSC辅助设门,分型根据抗体积分系统.并与FAB分型进行比较.[结果](1)62例成人白血病中未分化型占6.45%(4例),变异型占12.9%(8例).其中急性髓细胞白血病(AML)占69.35%(43例),B细胞型急性淋巴细胞白血病(B-ALL)占16.13%(10例),T细胞型急性淋巴细胞白血病(T-ALL)占6.45%(4例),AML/ALL为3.07:1.CD34的阳性率在62例成人急性白血病和6例慢性粒细胞性白血病急变患者中分别为58.06%和83.33%;免疫分型与FAB分型的符合率为83.9%.[结论]在流式细胞仪上采用CD45-SSC设门法多参数分析白血病免疫分型,并利用抗体积分系统诊断标准可为临床诊断提供重要依据.     

Abnormalities of the short arm of chromosome 9 with partial loss of material in hematological disorders

Clinical, hematological, and cytogenetic data of 32 patients with loss of part of the short arm of chromosome 9 (9p-) are reviewed. There were 20 acute lymphoblastic leukemia (ALL), seven non-Hodgkin lymphoma (NHL), three acute myeloid leukemia, one refractory anemia with excess blasts in transformation, and one chronic myeloid leukemia (CML) in blast crisis. The cytogenetic findings were heterogeneous: 13 cases of del(9)(p21), among them four as sole karyotypic change; five cases of del(9)(p12), three of them as sole karyotypic change; four patients with i(9q), three with unbalanced translocations involving 9p12; and seven with unbalanced translocations involving 9p21. In addition, 10 patients showed known specific translocations for determined subgroups of ALL, NHL, and CML. The immunological phenotypes in the 20 ALL patients were common ALL (35%), pre-B-ALL (35%), B-ALL (5%), T-ALL (15%), and null ALL (10%). Three NHL were of T cell origin and the others of B cell origin. No specific association between the karyotypic change, immunophenotype, and clinical presentation could be ascertained for patients with ALL, acute myeloid leukemia, CML in blast crisis, and B-NHL. In T-NHL, three children with deletion of 9p, T immunoblastic lymphoma originating from common thymocyte and presenting with a mediastinal mass and pleural effusion may constitute a definite subgroup with good prognosis. All other cases had a poor outcome. Previously suggested association of 9p- with T-ALL and "lymphomatous features" was not confirmed.     

71例急性白血病免疫表型特征分析及意义

目的:分析急性白血病(AL)免疫表型特点及其临床意义。方法:采用单克隆抗体直接免疫荧光标记法的流式细胞术,对71例AL进行免疫表型检测。结果:71例AL患者以系列专一型表达为主,同时亦存在抗原交叉表达、不表达特异性抗原及混合型等情况。AL患者CD34和HLA蛳DR表达分别占56.3 %和61.9 %,M3患者均不表达HLA蛳DR。My+ALL患者完全缓解(CR)率(60.0 %)低于My - ALL患者CR率(80.6 %),两组相比有显著性差异(P<0.05)。CD+34 ALL与CD蛳34 ALL患者缓解率基本相同;CD+34 AML患者CR率(58.3 %)明显低于CD蛳34 AML患者CR率(88.9 %),两组相比有显著性差异(P<0.05)。结论:白血病免疫表型检测结合FAB分型可以提高诊断的准确率,部分免疫表型特征对判断预后有一定的意义。     

急性淋巴细胞白血病患者 ASB2和 Jak3基因mRNA 表达的研究

目的：研究急性淋巴细胞白血病（ALL）患者骨髓中锚蛋白重复序列和抑制细胞因子信号盒蛋白2（ASB2）和 Janus 激酶3（Jak3）mRNA 的表达及其两者的相关性。方法收集初诊的48例 ALL患者（37例 B 细胞 ALL,11例 T 细胞 ALL）和34例非白血病患者（对照组）骨髓,采用实时荧光定量 PCR检测骨髓中 ASB2和 Jak3 mRNA 表达情况。结果B 细胞 ALL 和 T 细胞 ALL 患者骨髓中 ASB2 mRNA表达量相对于对照组分别升高了32．7倍和68．5倍,差异均有统计学意义（t ＝20．1,P ＜0．01;t ＝23．1, P ＜0．01）,Jak3 mRNA 表达量较对照组分别升高了2336．3和7131．5倍（t ＝70．2,P ＜0．01;t ＝90．4, P ＜0．01）。ASB2和 Jak3 mRNA 表达量具有相关性（r ＝0．523,P ＜0．001）。结论ASB2和 Jak3在 ALL患者骨髓中异常表达,且具有正相关性,两者可能共同参与白血病细胞的恶性增殖和异常分化。     

Immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen-positive childhood T-cell leukemia. A Pediatric Oncology Group Study

The immunologic and clinicopathologic features of common acute lymphoblastic leukemia antigen (CALLA)-positive and CALLA-negative T-acute lymphoblastic leukemia (ALL) and of CALLA-positive non-T, non-B ALL (common ALL) of childhood were compared. Twenty-seven percent of children with T-ALL had blasts that expressed CALLA. This expression was not associated with a significantly different incidence of expression of sheep erythrocyte-rosette receptors, glucocorticoid receptors, peanut agglutinin receptors, or T-cell antigens. CALLA-positive T-cell blasts were more likely to express a p24 leukemia-associated antigen (CD9, 50% versus 8%) and Ia antigens (39% versus 8%) than were CALLA-negative blasts. Patients with CALLA-positive and CALLA-negative T-ALL had similar clinicopathologic features at diagnosis. In contrast, compared to patients with common ALL, patients with CALLA-positive T-ALL were older, had higher leukocyte counts, and an increased incidence of splenomegaly, lymphadenopathy and mediastinal mass, similar to patients with CALLA-negative T-ALL. Patients with CALLA-positive T-ALL were more likely to achieve a complete remission (95% versus 83%, P = 0.055) and tended to have an increased duration of event-free survival (P = 0.07) than did patients with CALLA-negative T-ALL. The expression of T-cell antigens is more important than the expression of CALLA in defining biologically similar subgroups of childhood ALL. Preliminary evidence suggests that within T-ALL the expression of CALLA may be prognostically important.