急性淋巴细胞白血病细胞表面同时表现髓系统抗原40例的临床及免疫学分析

日本国三重大学小儿科近期约五年半期间,对过氧化酶阴性,a—NFA,NFA阴性、TdT阳性,形态学也表现为急性淋巴性白血病,免疫学诊断为ALL的264例中的40例(15.1%)表面抗原分析中发现除ALL特征外同时表现有髓系统抗原(CD11b,CD11c,CD13,CD14,CD15,CD16,CD33,CD36)仅表现一种髓系统抗原的24例,2种的6例,3种9例,5种抗原同时表现的1例。施行染色体分析的22例中正常核型仅2例其它均呈现了多种类型的染色体异常。进行了临床资料,免疫学的分析。预后方面有双标记(淋巴系髓系抗原同时表现)的病例尽管原来划归标危型ALL组也呈现了高再发率的不良结果,因此我们认为双标记的出现可以作为危险因子中的一个因子来选择更合适的化疗也许是必要的。

THE CLINICAL AND IMMUNOLOGICAL ANALYSIS ON 40 CASES OF ACUTE LYMPHOCYTIC LEUKEMIA WHO ALSO HAVE SIMUL TANEOUS MYELOGENOUS ANTIGENS EXPRESSED

40 in the 264 cases with ALL diagnosed according to the criteria of the peroxidase stain- ing negtive, a--NFA, NFA staining negtive, TdT positive, morphological pattern and im- munology also had the myelogenous antigens expressed simultaneously on surface of the tu- mour cellwere studied in the Division of Pediatrics in MIE University in Japan in recent five and half years. Of them, 24 cases had only one subtype, 9 had 2 subtypes, 6 had 3 subtypes antigen expression and 5 subtypes of antigen expression were found in one case. Only 2 in 22 cases had the normal karyotype on chromosome analysis while others had multiple abnormal karyotype. When the clinical and immunological data was combined in analysis,we found the prognosis of the cases who had double marker expression was poor though originally these cases were classified as standard risk type. We considered that the appearance of double marker expression indicates the patient had one of the high risk factors, so it is necessary to select individalized chemotherapy protocol for them.