急性白血病免疫表型与预后的关系

目的 探讨急性白血病(AL)免疫表型与预后的关系.方法 采用流式细胞技术(FCM)对75例AL患者进行免疫表型分析,并评价不同的免疫表型对预后的影响.结果 (1)82%的急性髓性白血病(AML)患者表达CD13、CD33、CD64、CD117,88%的急性淋巴细胞性白血病(ALL)患者表达CD2、CD3、CD7、CD19、CD20,伴淋系抗原表达的AML(Ly+AML)占13%,伴髓系抗原表达的ALL(My+ALL)占11%.(2)按免疫表型的表达特征,在AML和ALL中以系列专一表达所占的比例最高,且临床治疗预后较好.裸细胞型表达在AML和ALL中所占的比例最少,且临床治疗预后极差.杂合表达的病例中,CD7+的AML患者的完全缓解率(CR)明显低于系列专一表达者,预后极差.结论 AL免疫表型可出现系列专一表达、杂合表达及裸细胞型表达三种类型.杂合表达和裸细胞型表达的患者CR率低于系列专一表达者,临床预后不好.

Analysis of relationship between immunophenotype and prognosis of acute leukemia

Objective To study the relationship of immunophenotype and prognosis of acute leukemia(AL). Methods 75 patients with AL were analyzed immunophenotype expression by FCM and evaluated the effect of differ-ent immunophenotype to prognosis. Results (1) The incidence of CD13, CD33, CD64, CD117 expression in AML was 82%. The incidence of CD2, CD3, CD7, CD19, CD20 expression in ALL was 88%. The incidence of lymphocytic lineage antigen expression in AML(Ly + AML) was 13% and myeloid lineage antigen expression in ALL(My + ALL) was 11%. (2)According to the antigen expression, AL could be classified into three subgroups:lineage-specific expres-sion;mixture-lineage expression and null type. The lineage-specific expression was the highest in AML and ALL, and had a better clinical prognosis. The null type was the lowest neither in AML nor ALL and had a poorer clinical progno-sis. In mixture-lineage expression the CR rate of AML with CD7+ was the lowest than those with lineage-specific ex-pression and had poorer prognosis. Conclusions AL immtmophenotype might be devided into three subgroups:line-age-specific expression; mixture-lineage expression and null type. In the patients with CD7+ AML and null type ex-pression,lower CR rate and poorer prognosis were seen than those with lineage-specific expression. It needed to ex-plore new treatment methods.