急性单核细胞白血病M5a和M5b的细胞生物学和临床行为比较分析

目的比较急性单核细胞白血病M5a和M5b细胞遗传学和免疫表型差异,并了解其与临床行为之间的相互关系。方法采用骨髓直接法和24h短期培养法制备染色体标本，用G显带技术对58例成人初发急性单核细胞白血病进行核型分析，并用免疫荧光标记法及流式细胞术进行免疫表型检测，同时对其临床资料进行回顾性分析。结果58例患者中正常核型28例，异常核型30例，其中，正常核型在M5b出现率高于M5a（P〈0．01）。异常核型中11q23异常和＋8染色体在M5a中均较M5b常见（P〈0．01）；CD68和CD11b在M5a的表达高于M5b（P〈0．01）；不同患者急性单核白血病细胞的免疫表型呈现一定的异质性，但急性单核细胞白血病M5a、M5b两亚型的临床行为未见显著差异。结论M5a和M5b存在各自较独特的细胞生物学特点。

Comparison of Cytobiology and Clinical Behavior between M5a and M5b of Acute Monocytic Leukemia

Objective To compare the cytogenetic and immunophenotypic differences between M5a and M5b of acute monocytic leukemia and find out the relationship among them.Methods A total of 58 cases of de novo adult AML M5 were investigated. Chromosome preparations of bone marrow cells were made using direct and 24 h short-term culture method. Karyotypes were analyzed by G-banding. Immunofluresence analysis by flow cytometry was performed to detect the immunophenotype of the leukemic cells in all cases. Meanwhile, clinical information of these cases was studied retrospectively.Results There were 28 cases with normal karyotype and 30 cases with aberrant karyotype. The frequency of normal karyotype in M5b was higher than that in M5a (P<0.01). The 11q23 aberrations and the trisomy 8 were more common in M5a than in M5b (P<0.01). CD68 and CD11b were the leukemic cell antigens expressed higher in M5a than in M5b (P<0.01). The immunophenotypes of monocytic leukemic cells in patients with AML M5 were heterogeneous. However, there was no significant difference in clinical characteristics of the two categories.Conclusion The individual cytobiological features can be detected in leukemic cells from the patients with AML M5a and M5b.