急性粒细胞白血病患儿免疫表型及其临床意义

目的探讨儿童急性粒细胞白血病（AML）免疫分型及其临床意义。方法总结81例儿童AML的免疫表型与FAB分类、1个月骨髓缓解（CR）率及3年无病生存（EFS）率的关系。结果AML儿童1个月CR率为71.6%,3年EFS率为50.8%。HLA-DR缺失,CD34缺失主要见于急性早幼粒细胞白血病（M3）型,阴性患儿CR、EFS率明显高于阳性患儿。CD13阳性患儿的CR明显高于缺失患儿。CD33缺失在M2型中多见,特别是ETO阳性患儿。除外M3病例后分析,CD33缺失患儿的CR率明显高于阳性患者。淋系抗原表达率占34.6%,其中CD7阳性者CR率、EFS率均低于对照组,但无统计学差异。CD56与FAB分型中M2型有显著相关性,其CR率、EFS率均低于对照组。结论HLA-DR、CD34缺失主要见于M3型,是预后良好的指标。CD33缺失多见于M2型中ETO阳性患儿,预后好。淋系抗原、CD56表达多见于M2型,可能是预后差的指标。

Immunophenotype of Children with Acute Myeloid Leukemia and Its Clinical Significance

Objective To explore the immunophenotype of children with acute myeloid leukemia(AML) and its clinical significance.Methods Statistics was used to analyze the relationship between the immunophenotype of AML and their French-American-Britain(FAB) classification,complete remission (CR) in one month and 3-years event-free survival(EFS).Results CR rate was 71.6% and 3-years EFS rate was 50.8%. HLA-DR and CD34 absent mainly in M3, associated with higher CR and EFS rate. So did CD33 negative cases, especially in M2. CD13 positive was significantly predictive factor for achieving CR.Co-expression of lymphoid antigens and NK cell antigens(CD56) with M2 which correlated with lower CR and EFS rate.Conclusions The negative of HLA-DR, CD34, CD33,as well as CD13 positive, have relationship with good prognosis. Lymphoid antigens and CD56 are poor prognostic factors.