成人急性混合细胞白血病的临床研究

目的　分析成人急性混合细胞白血病 (AMLL)的免疫表型特征、细胞遗传学异常、临床疗效以及预后因素。方法　采用全血单克隆抗体直接免疫荧光标记法及流式细胞术检测细胞表面抗原和胞浆内抗原 ,P170检测采用全血单色间接免疫荧光标记法 ,染色体核型分析采用短期细胞培养胰酶消化G显带技术。结果　① 10例AMLL中 5例(5 0 % )为B淋巴细胞系和髓系两系抗原共同表达 ,3例 (30 % )为T、B淋巴细胞系和髓系三系抗原共同表达 ,2例 (2 0 % )为T淋巴细胞系和髓系两系抗原共同表达。②本组 8例CD34 阳性 ,占 80 % ;4例进行了P170检测 ,阳性 2例 (5 0 % ) ;6例进行了染色体检查 ,3例无分裂象。在可供染色体核型分析的 3例中 ,正常核型 1例 (33.3% ) ,异常核型 2型(66.7% )。③本组接受化疗的 8例中 ,仅 1例获得完全缓解 (CR) ,CR率为 12 .5 % ,1例 (12 .5 % )获得部分缓解 (PR) ,其余 6例 (75 .0 % )未缓解 (NR) ,总有效率为 2 5 .0 %。 5例发生较严重的感染 ,感染发生率为 62 .5 %。结论　AMLL以B淋巴细胞系和髓系两系抗原共同表达者最多 ,临床治疗CR率低 ,预后差

Study on the clinical characteristics of adult acute mixed-lineage leukemia

Objective To analyze the characteristics ofimmunophenotype and cytogenetics,treatment outcome and prognosis of adult acutemixed?lineage leukemia(AMLL).Methods Single? or dual?color monoclonal antibodies directly labeled with immunofluorescence were used to analyze the cellular surface and cytoplasmic antigens and the detections of P170 glycoprotein were performed with indirect single?color immunofluorescence byflow cytometry. The chromosome karyotypes were analyzed by G banding technique.Results ①In 10 patients, the percentage of B lymphoid and myeloid antigen coexpression was 50 percent and T lymphoid and B lymphoid andmyeloid antigen coexpression 30 percent, T lymphoid and myeloid antigen coexpression 20 percent.②The rate of CD 34 antigen expression was 80 percent.2 outof 4cases had over?expression of P170 glycoprotein. Cytogenetic analysis revealed normal karyotype in 1 out fo 3 cases and abnormal karyotypes in 2 out of 3 cases.③In 10 cases, 8 patients received chemotherapy. The complete remission rate was12.5 pecent and the total effective rate was 25 percent.Severe infections occurred to 5 out of 8 cases.Conclusion In AMLL, coexpressionof B lymphoid and myeloid antigens was the commonest subtype, the complete remission rate was low and the prognosis was poor.