高白细胞性急性白血病临床特征和免疫表型研究

目的探讨高白细胞性急性白血病的临床特征及免疫表型特点。方法采用流式细胞术对48例高白细胞性白血病(HLAL)和189例非高白细胞性白血病(NHLA)患者进行免疫表型检测,并对结果及临床特征进行分析。结果 HLAL与NHLAL比较,患者起病急,进展快,完全缓解(CR)率低(P<0.05),髓外浸润明显,骨髓增生活跃(P<0.05)。高白细胞性急性淋巴细胞白血病(HLALL)可以同时表达不同系列的抗原。HLALL、高白细胞性急性髓系白血病(HLAML)、非高白细胞性急性淋巴细胞白血病(NHLALL)与非高白细胞性急性髓系白血病(NHLAML)4组CD7抗原表达比较差异无统计学意义(P>0.05)。HLAML和NHLAML,髓系抗原表达阳性率较高的均为CD33和CD13。结论 HLAL与NHLAL相比进展较快,骨髓增生更为活跃,预后不良。急性淋巴细胞白血病(ALL)的白血病细胞异质性更高,尤其是HLALL。CD7系列特异性不明显,CD33和CD13作为髓系的特异性抗原较为可靠。

A research for immunophenotype characteristics and clinical feature of hyperleukocytic acute leukemia

Objective To investigate the immunophenotype characteristics of hyperleukocytic acute leukemia and to analyze its clinical feature.Methods Immunophenotyping was performed in 48 HLAL and 189 NHLAL patients by flow cytometry and its clinical feature has been analyzed.Results The results showed that as compared with NHLAL group,the clinical progress of HLAL was faster,the CR rate was lower(P<0.05),the infiltration was obvious,the proliferation of bone marrow was more active(P﹤0.05).The cross expressing positive rate of different lineage associated antigens was higher in HLALL group.The positive rate of CD7 expression was same in 4 groups.The positive rate of CD33 and CD13 was higher in HLAML and NHLAML group.Conclusion As compared with NHLAL,the clinical progress of HLAL was faster,the proliferation of bone marrow was more active,the treatment was more difficult.HLALL has high heterogeneity.The positive expression of CD7 has not specificity.CD33 and CD13 is more reliable to be myeloid-specific antigen.