成人急性双表型白血病的临床和生物学特征研究

目的：分析成人急性双表型白血病（BAL）的临床和生物学特征.方法：采用流式细胞术检测22例成人BAL患者治疗前骨髓细胞的免疫表型,染色体R显带技术对其中的16例进行核型分析.结果：在同期急性白血病496例患者中BAL发生率为4.4%（22/496）,16例（72.7%）为髓系和B系抗原共表达,5例（22.7%）为T系和髓系 抗原共表达,T系、B系和髓系均表达者1例 （4.5%）.BAL患者CD34阳性率为86.4%,高于同期ALL（60.3%）和AML（62.9%）（P＜0.05）.BAL患者中位年龄大于ALL患者（P＜0.05）.BAL组肝、脾、淋巴结肿大例数明显高于AML组（P＜0.01）.BAL组异常核型占56.3%,Ph染色体阳性率（25%）明显高于AML组（0%）（P＜0.01）.结论：成人BAL发病率低,以髓系和B淋巴系抗原共表达为主.BAL患者发病中位年龄高,高表达CD34,Ph染色体阳性者多见,肝、脾、淋巴结浸润发生率高.

Study on the clinical and biological characteristics of adult biphenotypic acute leukemia

Objective：To analyze the clinical and biological characteristics of adult biphenotypic acute leukelnia （BAL）. Methods：Twenty two adult patients with BAL were immunophenotyped by flow eytometry ,and 16 cases were also subjected to karyotype analysis by R - banding technology. Results ： Of 496 acute leukelnia patients, 22 cases （4.4%） were diagnosed as BAL. Alnong theln, 16 （72.7%） were B lymphoid and myeloid,5 （22.7%） were T lymphoid and myeloid, 1 （4.5 % ） was T, B lymphoid and lnyeloid trilineage differentiation. CD34 was expressed in 86.4% of BAL cases,which was higher than that in ALL （60.3%） or AML （62.9%） （P 〈 0.05）. The median age in BAL group was significantly higher than that in ALL group （P 〈 0.05）. The incidences d eulargelnent of liver, spleen and lymphonodes in BAL were higher than those in AML （P 〈 0.01）. Cytogenetie analysis revealed abnorlnul karyotypes in 56.3% of BAL cases and 25% of BAL patients had Philadelphia （Ph） ehromosolnes,which was signifi- cantly higher than that in AML group （0%） （P 〈0.01）. Conclusion：The incidence of adult BAL was lower and the co - expression of B lymphoid/myeloid antigens is the major feature of BAL. BAL patients showed a lnueh higher incidence of older age,CD34 antigen expression,presence of Ph ehromosolne, and liver,spleen and lymphonodes infil- tration.