急性粒-单核细胞白血病的免疫表型及细胞遗传学特征

背景与目的:白血病中某些抗原的表达与细胞遗传学的改变密切相关。本研究旨在探讨急性粒-单核细胞白血病(acutemyelomonocyticleukemia,M4)的免疫表型特征,并分析其与细胞遗传学的关系,为其诊断及治疗提供依据。方法:采用一组系列相关单克隆抗体和三色流式细胞术对81例M4患者进行免疫表型分析,并分析有核型资料的73例患者的核型异常;同时应用双色间期荧光原位杂交(fluorescenceinsituhybridization,FISH)技术对有染色体标本的35例患者进行inv(16)检测,并分析inv(16)阳性患者的免疫表型特征。结果:81例M4患者中48例(59.3%)表达干细胞标志CD34;髓系标志以CD33(84.0%)表达最高,其次为CD13(81.5%)和CD14(24.7%);分别有23例(28.4%)和10例(12.3%)患者表达T系和B系相关抗原。11例M4Eo患者中CD13均阳性,10例CD33阳性,7例CD34阳性,5例CD2阳性。FISH检测发现14例患者inv(16)阳性,其中CD13阳性13例,CD33阳性11例,CD34阳性8例,CD14阳性5例,CD7阳性3例,CD2阳性3例。73例M4患者中,异常染色体检出率为41.1%(30/73),共检出11种主要异常核型。CD2和CD34在染色体异常患者中表达明显增高,而CD14表达减低。CD2在M4Eo中表达增高,但其表达与inv(16)无显著性相关。结论:急性粒-单核细胞白血病以髓系抗原表达为主,CD2和CD34在染色体异常患者中表达明显增高;CD2在M4Eo中表达增高。Inv(16)在M4中占40%,各抗原表达与inv(16)无显著相关性。

Immunophenotypic and cytogenetic features of acute myelomonocytic leukemia

BACKGROUND & OBJECTIVE: The expression of some antigens has been involved in cytogenetic abnormalities in leukemia. This study was to explore the immunophenotypes of acute myelomonocytic leukemia (M4), analyze the correlation of M4 to cytogenetic abnormalities, and provide evidences for the diagnosis and therapy. METHODS: Immunophenotypic analysis was performed using a panel of monoclonal antibodies and three-color immunofluorescent staining methods of flow cytometry in 81 patients with M4 leukemia. Cytogenetic records of 73 patients were available, among which 35 were further investigated by dual-color interphase fluorescent in situ hybridization (FISH) and the immunophenotype of inv(16)-positive patients were analyzed. RESULTS: Among the 81 M4 leukemia patients, CD33 (84.0%) was the most commonly expressed antigen, followed by CD13 (81.5%) and CD14 (24.7%). CD34 was detected in 48(59.3%) patients. T lymphoid- and B lymphoid-associated antigens were expressed in 23 (28.4%) and 10 (12.3%) patients, respectively. All the 11 patients with M4Eo had CD13 expression. CD33, CD34, and CD2 were expressed in 10, 7, and 5 patients, respectively. Of the 14 patients with inv(16), 13 expressed CD13, 11 expressed CD33, 8 expressed CD34, 5 expressed CD14, 3 expressed CD7, and 3 expressed CD2. Of the 73 patients with cytogenetic records, 30(41.1%) had clonal chromosomal abnormalities. The expression of CD2 and CD34 was associated with karyotypic abnormalities. The expression of CD2 was higher in M4Eo patients, with no correlation to inv(16). CONCLUSIONS: Acute myelomonocytic leukemia mainly expresses myeloid lineage antigens. The expression of CD2 and CD34 is correlated to karyotypic abnormalities. The expression of CD2 is higher in M4Eo. Inv(16) exists in 40% of M4 patients and the expression of all the antigens has no correlation to inv(16).