[CD34(+)急性早幼粒细胞白血病患者的临床和实验室特征]

[Clinical and laboratory features of patients with CD34(+) acute promyelocytic leukemia].

作者信息

Liang Jian-ying, Wu De-pei, Liu Yue-jun, Ma Qin-fen, Xue Yong-quan, Zhu Ming-qing, Chen Zi-xing

机构信息

The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, Suzhou 215006, China.

出版信息

Zhonghua Zhong Liu Za Zhi. 2009 Mar;31(3):196-8.

PMID:19615259

Abstract

OBJECTIVE

To explore the expression of CD34 in patients with acute promyelocytic leukemia (APL) and investigate the clinical and laboratory features of CD34(+) APL patients.

METHODS

262 APL patients diagnosed by chromosome analysis and/or fusion gene examination in the last five years were retrospectively analyzed in this study. To survey the expression of CD34 in those patients, all the cases were divided into two groups (CD34(+) APL vs. CD34(-) APL). The clinical features including age, gender, abnormal values of the peripheral hemogram before treatment, the complete remission (CR) rate and the incidence of DIC and laboratory data such as the results of morphology, immunology, cytogenetics and molecular biology (MICM) between those two groups were compared.

RESULTS

Of the 262 APL patients, 38 (14.5%) cases were positive for CD34 expression. There were no statistically significant differences between CD34(+) APL and CD34(-) APL groups in gender and age (P > 0.05). Before treatment, the median level of WBC in CD34(+) APL was 25.92 x 10(9)/L, which was significantly higher than that of CD34(-) APL (5.3 x 10(9)/L, P < 0.05). CD34(+) APL by morphology classification were mostly of the subtypes M3b and M3v (65.8%), while these subtypes in CD34(-) APL (40.3%) were significantly less (P < 0.01). There were no statistically significant differences between the two groups compared in respect of complete remission (CR) rate and the incidence of DIC (P > 0.05). The expression level of CD34 in APL had correlation to the expression level of CD2, CD7 and CD117; the latter three phenotypes in CD34(+) APL were significantly higher than those in CD34(-) APL (P < 0.01). No significant difference was found between those two groups by chromosome analysis, but there was more PML-RAR-alpha transcript short form in CD34(+) APL than that in CD34(-) APL (P < 0.05).

CONCLUSION

CD34(+) acute promyelocytic leukemia is a unique subtype of APL with different biological characteristics.

摘要

目的

探讨急性早幼粒细胞白血病（APL）患者中CD34的表达情况，并研究CD34(+) APL患者的临床及实验室特征。

方法

本研究回顾性分析了近五年内经染色体分析和/或融合基因检测确诊的262例APL患者。为调查这些患者中CD34的表达情况，所有病例被分为两组（CD34(+) APL组与CD34(-) APL组）。比较两组患者的临床特征，包括年龄、性别、治疗前外周血常规异常值、完全缓解（CR）率和弥散性血管内凝血（DIC）发生率，以及形态学、免疫学、细胞遗传学和分子生物学（MICM）等实验室数据。

结果

在262例APL患者中，38例（14.5%）CD34表达呈阳性。CD34(+) APL组与CD34(-) APL组在性别和年龄方面无统计学显著差异（P > 0.05）。治疗前，CD34(+) APL患者的白细胞中位数水平为25.92×10⁹/L，显著高于CD34(-) APL患者（5.3×10⁹/L，P < 0.05）。形态学分类显示，CD34(+) APL大多为M3b和M3v亚型（65.8%），而CD34(-) APL中的这些亚型（40.3%）明显较少（P < 0.01）。两组在完全缓解（CR）率和DIC发生率方面比较无统计学显著差异（P > 0.05）。APL中CD34的表达水平与CD2、CD7和CD117的表达水平相关；CD34(+) APL中后三种表型显著高于CD34(-) APL（P < 0.01）。染色体分析显示两组间无显著差异，但CD34(+) APL中的PML-RAR-α转录本短形式比CD34(-) APL更多（P < 0.05）。