Liu Bin, Li Rui, Wu Hui-Jing, Chen Yan
Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2007 Apr;15(2):421-4.
The purpose of this study was to investigate the prognosis of acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), lymphoid antigen-positive acute myeloid leukemia (Ly + AML), myeloid antigen-positive acute leukemia (My + ALL) and biphenotypic acute leukemia (BAL). Immunophenotyping was performed on medullary specimens of 197 acute leukemia (AL) patients by using three-color flow cytometry analysis and CD45/SSC gating. The scoring systems proposed by EGIL was adopted to classify the AL patients into five groups: 43 of ALL, 53 of AML, 53 of My + ALL, 39 of Ly + AML and 9 of BAL patients. The results showed that in Ly + AML, CD7 was the most common (53.8%) as compared to other lymphoid markers, however, in My + ALL CD13 was the most common (47.2%) as compared to other myeloid markers. Compared with Ly + AML, My + ALL had higher incidences of enlargement of liver, spleen and lymphnodes significantly (P<0.05). As for the case numbers of WBC counts > 100 x 10(9)/L, the positive rate of CD34 and the complete remission rate there was no obvious difference between groups of Ly + AML and My + ALL (P>0.05). As for incidences of enlargement of liver, spleen and lymphnodes, the case numbers of WBC counts > 100 x 10(9)/L, the positive rate of CD34 and complete remission rate, no obvious difference was found between ALL and My + ALL (P>0.05). Compared with AML, Ly + AML had lower complete remission rate significantly (P<0.05). As for incidences of enlargement of liver, spleen and lymphnodes, the case numbers of WBC counts > 100 x 10(9)/L and the positive rate of CD34, no obvious difference was found between AML and Ly + AML (P>0.05). Compared with Ly + AML and My + ALL, BAL showed no significant difference in complete remission rate (P>0.05) because the number of BAL patients was too small. It is concluded that since Ly + AML has lymphoid markers, and the prognosis of Ly + AML is worse than AML, the clinical therapy for Ly + AML should contain both AML and ALL. Though My + ALL had myeloid markers, no significant difference was found between My + ALL and ALL, it might be supposed that their therapy could be the same.
本研究旨在探讨急性髓系白血病(AML)、急性淋巴细胞白血病(ALL)、淋巴系抗原阳性急性髓系白血病(Ly + AML)、髓系抗原阳性急性淋巴细胞白血病(My + ALL)及双表型急性白血病(BAL)的预后。采用三色流式细胞术分析及CD45/SSC设门法,对197例急性白血病(AL)患者的骨髓标本进行免疫表型分析。采用EGIL提出的评分系统将AL患者分为五组:ALL患者43例,AML患者53例,My + ALL患者53例,Ly + AML患者39例,BAL患者9例。结果显示,在Ly + AML中,与其他淋巴系标志物相比,CD7最为常见(53.8%);然而,在My + ALL中,与其他髓系标志物相比,CD13最为常见(47.2%)。与Ly + AML相比,My + ALL患者肝、脾及淋巴结肿大的发生率显著更高(P<0.05)。至于白细胞计数>100×10⁹/L的病例数、CD34阳性率及完全缓解率,Ly + AML组与My + ALL组之间无明显差异(P>0.05)。至于肝、脾及淋巴结肿大的发生率、白细胞计数>100×10⁹/L的病例数、CD34阳性率及完全缓解率,ALL组与My + ALL组之间未发现明显差异(P>0.05)。与AML相比,Ly + AML的完全缓解率显著更低(P<0.05)。至于肝、脾及淋巴结肿大的发生率、白细胞计数>100×10⁹/L的病例数及CD34阳性率,AML组与Ly + AML组之间未发现明显差异(P>0.05)。与Ly + AML和My + ALL相比,BAL的完全缓解率无显著差异(P>0.05),因为BAL患者数量过少。结论是,由于Ly + AML具有淋巴系标志物,且Ly + AML的预后比AML差,Ly + AML的临床治疗应同时包含AML和ALL的治疗方法。虽然My + ALL具有髓系标志物,但My + ALL与ALL之间未发现显著差异,可以推测它们的治疗方法可能相同。