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[急性白血病亚型Ly + AML和My + ALL预后的临床研究]

[Clinical study on prognosis of acute leukemia subtypes Ly + AML and My + ALL].

作者信息

Liu Bin, Li Rui, Wu Hui-Jing, Chen Yan

机构信息

Department of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2007 Apr;15(2):421-4.

Abstract

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.

摘要

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。

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