Schardt C, Hoelzer D, Ganser A
Department of Hematology, University of Frankfurt/Main, Federal Republic of Germany.
Ann Hematol. 1992 Feb;64(2):72-7. doi: 10.1007/BF01715348.
We examined the configuration of the immunoglobulin genes in the leukemic blast cell DNA of 20 adults with precursor B-cell acute lymphoblastic leukemia (ALL), treated according to the BMFT protocol. Sixteen of 20 (80%) patients expressed HLA-DR antigens and lacked detectable T-cell antigens. Eleven of the 20 patients (55%) were positive for the CD10 antigen and therefore classified as common ALL. Six patients were classified by immunological phenotyping as null-ALL (30%). Three patients (15%) expressed both immature B-cell markers CD19, CD22, or CD24 and myelomonocytic markers CDw65 or CD15, suggesting precursor B-ALL with cross-lineage expression of myeloid markers. In 18 of the 20 patients (90%), rearrangements and/or deletions of the immunoglobulin heavy-chain (IgH) gene locus were found. In none of the patients was a light-chain gene rearrangement observed. Two patients (10%) had a rearrangement of one allele for the J beta 1 gene region of the TCR-beta gene. In four patients (20%) more than two hybridizing bands for the IgH genes were detected. Two of these four patients with multiple hybridizing bands for the IgH genes had a t (4;11) translocation. Two of five patients with the t (4;11) translocation co-expressed both B-cell antigens and the myeloid antigens CD15 or CDw65. No correlation was found between the immunophenotype of the ALL and the arrangement pattern of their IgH genes. Kaplan-Meier plot analysis revealed no significant difference between adult precursor B-ALL patients with monoclonal or oligoclonal IgH gene rearrangements and their disease-free survival rates.
我们检测了20例按照BMFT方案治疗的成年前体B细胞急性淋巴细胞白血病（ALL）患者白血病原始细胞DNA中免疫球蛋白基因的构型。20例患者中有16例（80%）表达HLA - DR抗原且未检测到T细胞抗原。20例患者中有11例（55%）CD10抗原呈阳性，因此被归类为普通ALL。6例患者经免疫表型分析归类为无标记ALL（30%）。3例患者（15%）同时表达未成熟B细胞标志物CD19、CD22或CD24以及髓单核细胞标志物CDw65或CD15，提示前体B - ALL伴有髓系标志物的跨系表达。20例患者中有18例（90%）发现免疫球蛋白重链（IgH）基因位点的重排和/或缺失。未观察到任何患者有轻链基因重排。2例患者（10%）TCR - β基因的Jβ1基因区域一个等位基因发生重排。4例患者（20%）检测到IgH基因有两条以上杂交带。这4例IgH基因有多个杂交带的患者中有2例发生了t(4;11)易位。5例发生t(4;11)易位的患者中有2例同时共表达B细胞抗原和髓系抗原CD15或CDw65。未发现ALL的免疫表型与其IgH基因排列模式之间存在相关性。Kaplan-Meier曲线分析显示，成年前体B - ALL患者单克隆或寡克隆IgH基因重排与其无病生存率之间无显著差异。
