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慢性B淋巴细胞白血病和白血病性免疫细胞瘤的免疫表型与预后

Immune phenotype and prognosis in chronic B-lymphocytic leukaemia and leukaemic immunocytoma.

作者信息

Juliusson G, Ost A, Biberfeld P, Robèrt K H, Gahrton G

出版信息

Acta Med Scand. 1985;218(3):335-40. doi: 10.1111/j.0954-6820.1985.tb06134.x.

Abstract

Fifty-nine patients with a leukaemic B-lymphocytic malignancy ("CLL") were studied. According to the Kiel classification, 29 patients had chronic lymphocytic leukaemia (CLL) and 30 had immunocytoma (IC). Cell surface immunoglobulin staining showed mu heavy chain phenotype in 14 patients, mu in 35, gamma in 7; in cells from 3 patients the staining was too weak to permit identification. The light chain phenotype was kappa in 39 patients, lambda in 17, and unidentified in 3. The immunoglobulin isotypes differed between the diagnoses. The gamma chain phenotype was found only in IC patients (p less than 0.02), and more CLL than IC patients showed a lambda chain phenotype (p less than 0.04). Blood lymphocytes from IC patients contained more T cells than CLL cell samples (p less than 0.002). No prognostic difference was found between the CLL and IC group. Compared to the lambda phenotype, the kappa phenotype was associated with a poorer prognosis in the IC group, but with a better prognosis in the CLL group. IC patients with mu phenotype had a poorer prognosis than those with gamma phenotype. Low relative T cell numbers were associated with a poor survival (p less than 0.01).

摘要

对59例患有白血病性B淋巴细胞恶性肿瘤(“慢性淋巴细胞白血病”)的患者进行了研究。根据基尔分类法,29例患者患有慢性淋巴细胞白血病(CLL),30例患有免疫细胞瘤(IC)。细胞表面免疫球蛋白染色显示,14例患者为μ重链表型,35例为μ,7例为γ;3例患者的细胞染色太弱,无法进行鉴定。轻链表型在39例患者中为κ,17例为λ,3例未确定。免疫球蛋白同种型在不同诊断之间存在差异。γ链表型仅在IC患者中发现(p<0.02),且CLL患者中显示λ链表型的比IC患者更多(p<0.04)。IC患者的血液淋巴细胞比CLL细胞样本含有更多的T细胞(p<0.002)。CLL组和IC组之间未发现预后差异。与λ表型相比,κ表型在IC组中与较差的预后相关,但在CLL组中与较好的预后相关。具有μ表型的IC患者比具有γ表型的患者预后更差。相对T细胞数量低与生存不良相关(p<0.01)。

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