成人急性淋巴细胞白血病的分型探讨

目的 研究成人急性淋巴细胞白血病(ALL)生物学特征,分析WHO 2008年ALL分类的变化.方法 应用流式细胞术、R显带常规核型分析法、RT-PCR技术对初诊成人ALL患者进行免疫学、细胞遗传学、分子生物学检测.结果 ①共412例初诊成人ALL患者,男性239例,女性173例.免疫表型可分析病例410例,B系357例...

Probe of classification of adult acute lymphoblastic leukemia

Objective To investigate the biologic features of adult acute lymphoblastic leukemia (ALL) ,and reclassified our ALL patients according to the 2008 WHO classification. Methods Immunophenotype and cytogenetic/molecular genetic results were obtained by flow cytometry, R-banding and RT-PCR,respectively. Results ① A total of 412 newly diagnosed and previously untreated adult ALL patients, were 239 males and 173 females. Among 410 patients with available immunophenotypic results, 357 were B-ALL and 53 T-ALL Myeloid antigen (MyAg) was higher expression in B-ALL than in T-ALL, and was correlated with the expression of CD34. ②93 Ph+ ALL patients, mainly CD10+ ALL, was associated with high WBC count and MyAg and CD34 expression. MLL rearrangement was found in 12 cases , mainly pro-B ALL .③299 cases could be analysed, according to the 2008 WHO classification of ALL, including 126 B-ALL with recurrent genetic abnormalities, and 120 B-ALL not otherwise specified. Among the 126 B-ALL with recurrent genetic abnormalities, 92 were Ph+ALL, 10 MLL + ALL, 11 hyperdiploid, 9 hypodiploid, 3 E2A-PBX+ , and 1 TEL-AML1 +. Patients with Ph+ , MLL+ , hypodiploid or E2A-PBX+ were associated with older age, higher WBC count, higher HGB, higher peripheral blasts and higher LDH level as compared with other patients.Conclusion Combination of immunophenotype and cytogenetic-molecular profiles can provide a further detailed classification of B-ALL.