急性白血病患者白血病细胞CD19和CD20反应谱分析

目的 观察CD19和CD20在急性白血病 (AL)细胞中的表达与分布 ,为免疫毒素导向治疗药物的合理应用提供依据。方法 采用27个直接荧光素标记的单克隆抗体 (单抗 )及CD45/SSC双参数设门多色流式细胞术对321例AL患者白血病细胞进行免疫学诊断和分型 ,并对CD19和CD20在各种类型AL细胞中的表达情况进行分析。 结果 在116例B系ALL患者中 ,CD19持续稳定表达 ,其阳性率(99.1%)高于CD20阳性率(28.4%,P=0.001) ;在17例具B系特征的杂合型白血病 (HAL)细胞中 ,CD19阳性率也明显高于CD20(P<0.01) ,而在29例T细胞系ALL和7例T/MyHAL细胞中 ,两者均无表达。在152例急性髓系白血病(AML)细胞中 ,CD19和CD20阳性率均很低 ,分别为7.2%和2.0%。 结论 CD19在B细胞系细胞的各分化阶段上持续稳定表达 ,且反应谱比CD20宽 ,CD19免疫毒素可能成为治疗大多数B系ALL的最佳选择。

The comparison of expression patterns of CD19 and CD20 on 321 cases of acute leukemia

objective To investigate the expression and distribution of CD19 and CD20 on acute leukemia (AL) cells, and to provide evidences for selecting immunotoxin. Methods Samples from 321 AL patients were analyzed by CD45/SSC double parameters and multi-color flow cytometry using a panel of 27 fluorescein- labeled monoclonal antibodies, to determine the expression of CD19, CD20 and other leukocyte differentiation antigens. Results Among 116 cases of B lineage ALL, CD19 is continuously and stably expressed. The positive rate (99.1%) of CD19 on B lineage ALL was higher than that of CD20 (28.4%,P = 0.001). The positive rates of CD19 in all 17 cases of B-lineage hybrid acute leukemia (HAL) including B/myeloid (My) and B/T lineage (HAL) were also significantly higher than that of CD20 (P < 0.001), while CD19 and CD20 were not expressed in the 29 cases of T lineage leukemia and 7 cases of T/My HAL. Among 152 cases of acute myeloid leukemia (AML),the positive rates of CD19 and CD20 were only 7.2% and 2.0%, respectively.Conclusion CD19 is continuously and stably expressed on all stages of B lineage differentiation, so that this antigen might be an ideal target for antibody-targeting treatment of B lineage ALL.