Jiang Neng-Gang, Chen Xiao-Mei, Zhu Huan-Ling, Zhong Ling, Zeng Ting-Ting, Jia Yong-Qian
Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2010 Dec;18(6):1405-9.
The aim of study was to investigate the immunophenotype characteristics and prognosis of acute leukemia patients with cross-expressing lymphoid and myeloid lineage-associated antigens. The immunophenotypes of leukemic cells were examined by using flow cytometry. All patients were classified into several groups according to FAB subtypes and immunophenotyping. The cross-expressed antigens analyzed for AML included CD2, CD7, CD19, CD56 and other co-expressed lymphoid antigens. The myeloid antigens analyzed for ALL included CD13 and co-expressed CD13/CD33. ALL and AML patients without expression of cross-expressing antigens were selected as control. Complete remission (CR) ratio and relapse-free survival (RFS) of patients in all groups were compared. The results indicated that among 161 patients analyzed, 91 cases of AML with cross-expressing lymphoid and myeloid antigens included that 24 cases of AML expressed lymphoid surface marker-CD7, namely CD7(+) AML, 14 cases of AML only expressed lymphoid surface marker-CD19, namely CD19(+) AML, 8 cases of AML expressed lymphoid surface marker-CD2 (including CD2/CD19 co-expressed), namely CD2(+) AML, 10 cases of AML expressed lymphoid surface marker-CD56 (including CD56/CD19 or CD56/CD2 co-expressed), namely CD56(+) AML, 16 cases of AML expressed two or more lymphoid surface markers, namely Ly ≥ 2(+) AML, 9 cases of ALL expressed myeloid surface markers CD13, namely CD13(+) ALL, 10 cases of ALL expressed myeloid surface markers CD13 and CD33, namely CD13/CD33(+) ALL. 29 cases of ALL did not expressed myeloid surface markers, namely My(-) ALL, and 41 case of AML did not expressed lymphoid surface markers, namely Ly(-) AML. CR ratio and RFS of Ly ≥ 2(+) AML patients were lower than those of Ly(-) AML patients. RFS of CD56(+) AML patients was lower, but CR ratio had no significant difference, when compared with Ly(-) AML patients. CR ratio and RFS of other AML patients with cross-expressing antigens had no significant difference when compared with Ly(-) AML patients. CR ratio and RFS of CD13(+) ALL and CD13/CD33(+) ALL patients had no significant difference when compared with My(-) ALL patients. It is concluded that the importance of cross-expressing antigens for prognosis of patients should be analyzed concretely. CD56(+) AML and Ly ≥ 2(+) AML have bad prognosis, while other cross-expressed lymphoid and myeloid lineage-associated antigens have no impact on prognosis of acute leukemia patients.
本研究旨在探讨同时表达淋巴系和髓系相关抗原的急性白血病患者的免疫表型特征及预后。采用流式细胞术检测白血病细胞的免疫表型。所有患者根据FAB亚型和免疫表型进行分组。分析的急性髓系白血病（AML）交叉表达抗原包括CD2、CD7、CD19、CD56及其他共表达的淋巴系抗原。分析的急性淋巴细胞白血病（ALL）髓系抗原包括CD13及共表达的CD13/CD33。选择无交叉表达抗原的ALL和AML患者作为对照。比较各组患者的完全缓解（CR）率和无复发生存（RFS）率。结果显示，在分析的161例患者中，91例AML同时表达淋巴系和髓系抗原，其中24例AML表达淋巴系表面标志物CD7，即CD7(+)AML；14例AML仅表达淋巴系表面标志物CD19，即CD19(+)AML；8例AML表达淋巴系表面标志物CD2（包括CD2/CD19共表达），即CD2(+)AML；10例AML表达淋巴系表面标志物CD56（包括CD56/CD19或CD56/CD2共表达），即CD56(+)AML；16例AML表达两种或更多淋巴系表面标志物，即Ly≥2(+)AML；9例ALL表达髓系表面标志物CD13，即CD13(+)ALL；10例ALL表达髓系表面标志物CD13和CD33，即CD13/CD33(+)ALL。29例ALL不表达髓系表面标志物，即My(-)ALL；41例AML不表达淋巴系表面标志物，即Ly(-)AML。Ly≥2(+)AML患者的CR率和RFS低于Ly(-)AML患者。与Ly(-)AML患者相比，CD56(+)AML患者的RFS较低，但CR率无显著差异。其他交叉表达抗原的AML患者与Ly(-)AML患者相比，CR率和RFS无显著差异。CD13(+)ALL和CD13/CD33(+)ALL患者与My(-)ALL患者相比，CR率和RFS无显著差异。结论是，应具体分析交叉表达抗原对患者预后的重要性。CD56(+)AML和Ly≥2(+)AML预后较差，而其他交叉表达的淋巴系和髓系相关抗原对急性白血病患者的预后无影响。
