慢性髓系白血病急变期中免疫分型研究

 目的 探讨慢性髓系白血病急变期（CML-BC）的免疫表型特征及应用价值。方法 采用一组单克隆抗体和三色流式细胞术对36例成年人CML-BC骨髓标本进行免疫表型分析。结果 36例CML-BC患者中急性非淋巴细胞白血病变30例（83.33 %），其中40 %（12／30）伴淋系表达；急性淋巴细胞白血病变急淋变3例（8.33 %），其中66.67 %（2／3）伴髓系表达；急性混合型白血病变2例；急性未分化型白血病变1例。CML-BC以CD33阳性率最高91.67 %，其次是CD+13 86.11 %，CD+34 61.11 %，CD+7 33.33 %，CD+10 19.44 %，CD+19 16.67 %，CD+2 2.78 %，CD+20 5.56 %及CD+14 5.56 %。CD7与CD34共阳性27.78 %。结论 CML-BC免疫表型复杂，多系表达常见。免疫分型可协助判断CML的急变类型。

Study on the immunophenotype of blast crisis in chronic myeloid leukemia

Objective To characterize the immunophenotype of chronic myeloid leukemia in blast crisis (CML-BC). Methods Immunophenotypic analysis was performed using a panel of monoclonal antibodies and three-colour immunofluorescence staining methods of flow cytometry in 36 patients with CML in BC. Results Of the 36 CML-BC, 30 patients (83.3 %) were acute nonlymphocytic leukemia (ANLL) transformation, 12 of them simultaneously expressed lymphoid associated antigens, 3 patients (8.33 %) were acute lymphoid leukemia (ALL) transformation and 2 of them simultaneously expressed myeloid associated antigens. Another 3 cases were classified as acute undifferentiated leukemia (AUL) and 2 hybrid acute leukemia (HAL). Among the 36 CML-BC cases, CD33 was the most commonly expressed antigen in CML-BC: 91.67 %, followed by CD13 86.11 %, CD34 61.11 %, CD7 33.33 %, CD10 19.44 %, CD19 16.67 %, CD2 2.78 %, CD20 5.56 %, CD14 5.56 %, respectively. CD34 and CD7 were coexpressed in 10 out of 36 cases. Conclusion The present study confirms the lineage heterogeneity of CML-BC, co-expression of markers from two or three lineages is frequent. Immunophenotyping is important in accurate classification of CML-BC.