Cabrera M E, Labra S, Ugarte S, Matutes E, Greaves M F
Sección Hematología, Facultad de Medicina, Universidad de Chile (Campus Oriente), Hospital del Salvador, Santiago de Chile.
Rev Med Chil. 1996 Mar;124(3):293-9.
We describe the clinical features and immunophenotype of 500 children and 131 adults with acute lymphoblastic leukemia (ALL), diagnosed between 1984 and 1993. Cases were classified, according to immunophenotype in B-cell ALL with three subtypes (pro-B or null, common and B) and T-cell ALL. Among children, common ALL accounted for 74% of cases and pro-B all was more common in children of less than one year (14%). B ALL was observed in 2% of children. Ten percent of children, mostly males, had T-cell ALL. The third part of these children had high leukocyte counts and a mediastinal mass. Children from Mapuche origin, compared with Caucasian children had a lower proportion of common ALL (36 and 74% respectively) and a higher proportions of T-cell ALL (41 and 10% respectively). Among adults common ALL was the most common phenotype (72%) followed by T-cell ALL (15%), pro-B ALL (11%) and B-cell ALL (2%). There was a lower incidence of children with common ALL with positive cytoplasmic immunoglobulin compared to North American or European studies (2 and 15-33% respectively) and a higher proportion of adults with common ALL compared with pro-B cell ALL, in contrast to European studies that show a higher proportion of patients with pro-B cell ALL. No other immunophenotypic, clinical or laboratory differences were observed with ALL from developed countries. It is concluded that the immunophenotyping of ALL allows a more precise diagnosis of this disease.
我们描述了1984年至1993年间诊断的500名儿童和131名成人急性淋巴细胞白血病(ALL)的临床特征和免疫表型。病例根据免疫表型分为B细胞ALL的三个亚型(前B或无、普通和B)和T细胞ALL。在儿童中,普通ALL占病例的74%,前B ALL在1岁以下儿童中更常见(14%)。2%的儿童观察到B ALL。10%的儿童,主要是男性,患有T细胞ALL。这些儿童中有三分之一白细胞计数高且有纵隔肿块。与白种儿童相比,马普切族儿童普通ALL的比例较低(分别为36%和74%),T细胞ALL的比例较高(分别为41%和10%)。在成人中,普通ALL是最常见的表型(72%),其次是T细胞ALL(15%)、前B ALL(11%)和B细胞ALL(2%)。与北美或欧洲的研究相比,细胞质免疫球蛋白阳性的普通ALL儿童发病率较低(分别为2%和15 - 33%),与前B细胞ALL相比,成人普通ALL的比例较高,这与显示前B细胞ALL患者比例较高的欧洲研究相反。未观察到与发达国家ALL在免疫表型、临床或实验室方面的其他差异。结论是ALL的免疫表型分析有助于更精确地诊断这种疾病。