急性双表型白血病细胞遗传学分型特征的研究

背景与目的：自1995年白血病免疫分型欧洲协作组（EGIL）推荐了一套积分系统用于白血病免疫分型以来,关于急性双表型白血病（BAL）的细胞遗传学特征国内外均有报道,但病例数较少,本文研究了一组BAL的细胞遗传学分型特征。方法：56例BAL患者骨髓标本进行细胞形态学及细胞化学染色,确定其FAB亚型;运用一组系列相关单克隆抗体和流式细胞仪及直接免疫荧光标记技术进行免疫分型;采用热变性姬姆萨R显带法（reverse heating giemsa,RHG)进行核型分析。结果：本组资料揭示BAL患者细胞遗传学改变具有异质性,正常核型占44.4%,克隆性异常占55.6%。在克隆异常中Ph染色体改变占23.2%高于对照组AML组（0%）,且在B淋系、髓系共表达患者组中（39.3%)高于T淋系、髓系共表达患者组（0%）。其它相关性克隆性染色体异常有t(8;21)、t(15;17)、t(9;22)、inv(16)、非相关性染色体异常有t(12;17)、t(14;15)、t(3;6)、 21、复合异常等。结论：BAL患者Ph染色体改变具有普遍性,说明它起源于比较早期的造血干/祖细胞。

Cytogenetic feature of acute biphenotypic leukemia

Background &Objective:Since the diagnostic criterion of acute biphenotypic leukemia(BAL)was recommended by European Group for th e Immunological Characterics of Leu kemia(EGIL)in 1995,the reports on cytogenetic feature of BAL can be seen in homeland and outside ,but the case numbers in the reports were low .Thi s study was designed to explore the cytogenetic feature of BAL.Methods:The FAB subsets of fifty-six BAL case s were established by morphology /cytochemistry;and sur face immunophenotyping was perform ed by flow cytometry using a broad pan el of lymphoid-and myeloid-associated monoclonal antibodies through directly immunofluorescence technique;karyotype analysis was carried out by reverse heating giemsa(RHG).Results:The data from our study showed that th e cytogenetic feature of BAL possess a certain degrees of hete rogeneity .In all cases,44.4%were n ormal karyotype,55.6%were clonal chromosome aberration.In clonal ch romosome aberration,Ph chromosome abnormality occurred 23.2%and in ma tched AML controls was 0%.Ph chromosome ab normality occurred 39.3%in group of coexpression of myeloid and B lymphoid lineage;Ph chromosome aberration o ccurred 0%in group of coexpression o f myeloid and T-lymphoid lineage.The other associated clonal chromosome aberrations were t (8;21),t (15;17),t (9;22),inv(16),and not associated clonal chromosome aberration were t (12;17),t (14;15),t (3;6),+21,complex aberration,etc.Conclusion:The generalized abnormality of t (9;22)in BAL indicate that the blast cells of BAL were derived from earlie r hematopoietic stem /progenitor cell.