累及单核细胞系急性白血病的免疫表型和遗传学研究

目的　探讨急性髓系白血病-M4、M5亚型的细胞遗传学、免疫表型特征。方法　应用染色体G显带、间期荧光原位杂交技术和流式细胞术对30例M4、M5患者进行遗传学分析和免疫表型检测。结果　染色体分析:30例M4、M5中共发现13例伴有11q2 3染色体异常,总发生率为4 3 3% ,其中M5a 1例、M5b 8例、M4b 4例,异常核型有6种:t (11;19) 4例;t(11;17) 2例;t(9;11) 2例;t(10 ;11) 1例;t(6 ;11) 1例;t(11;?) (q2 3;?) 1例;del(11)(q2 3) 2例。I-FISH检测MLL基因异常共13例阳性,其中M5 8例,M4 5例。免疫表型检测各种抗原阳性率依次为HLADR(92 % ) ,CD33(92 % ) ,CD6 4 (85 % ) ,CD11b(80 % ) ,CD15 (79% ) ,CD117(79% ) ,CD13(6 9% ) ,CD34(6 1% ) ,CD5 6 (38 5 % ) ,CD14 (31% ) ,CD3(14 % ) ,CD2 (7% ) ,CD7(7% )。结论　11q2 3异常在AML -M5 /M4中发生率高,该组患者高表达早期干祖细胞标志CD34、CD117、HLA -DR ,具有独特的遗传学、免疫学特点。

Study on cytogenetics and immunophenotype of acute myelomonocytic and monocytic leukemia

Objective To study the cytogenetic and immunophenotype features in acute monocytic leukemia(M5) and acute myelomonocytic leukemia(M4). Methods Thirty cases of AML-M4 and AML-M5 were studied in genetics by the G-banding techniqne, interphase fluorescence in situ hybridization (I-FISH) and flow cytometry immunophenotyping. Results 11q23 abnormalities were found in 13 of 30 cases with M4 and M5. The incidence of 11q23 abnormalities was 43.3%, including 9 cases with M5(M5a, one; M5b, eight) and 5 cases with M4. Karyotype analysis showed following abnormalities: t(11;19)(4 cases), t(11;17)(2 cases), t(9;11)(2 cases), t(10;11)(1 case), t(6;11)(1 case), t(11;?)(q23;?)(1 case) and del(11)(q23)(2 cases). MLL genes abnormalities were found by FISH analysis in thirteen cases including 8 cases with M5 and 5 cases with M4. Immunophenotyping(positivity) induded HLADR(92%),CD33(92%),CD64(85%),CD11b(80%),CD15(79%),CD117(79%),CD13(69%),CD34(61%),CD56(38.5%),CD14( 31%),CD3(14%),CD2(7%) and CD7(7%). Conclusion There is high incidence of 11q23 abnormalities in AML-M5 / M4, and the stem cell marker CD34, CD117 and HLA-DR are highly expressed, representing unique cytogenetic and immunophenotypic features.