102例儿童急性淋巴细胞性白血病免疫分型、细胞遗传学改变及临床特征分析

Analisis of Immunophenotypic,Cytogenetic and Clinical Features for 102 Children Acute Lymphoblastic Leukemia Patients

目的对102例儿童急性淋巴细胞性白血病(acute lymphoblastic leukemia,ALL)的免疫表型,细胞遗传学改变及其临床特征进行总结和分析。方法对102例初治急性淋巴细胞性白血病患儿进行FBA分型并采用流式细胞术检测白血病细胞的免疫表型,G显带技术对68例患儿进行染色体核型分析。结果 102例患儿中15.7%表达T淋巴细胞表型(T-ALL),84.3%表达B淋巴细胞表型(B-ALL)。35.3%患儿存在髓系抗原阳性(My+-ALL),其中以CD13阳性率最高,达27.8%。88接受核型检查的患儿发现核型异常41例(51.3%)。T-ALL组患儿与B-ALL组患儿相比显示出更高的白细胞总数(>50×109/L)和髓外浸润表现。结论免疫分型是对细胞形态学诊断的有力补充,能够更加全面了解白血病细胞的起源和分化阶段,帮助对患儿进行临床危险的评估,选择适宜的治疗方案并有效评估预后提供依据。

【Objective】The aim is to summarize and analyze the immunophenotype,cytogenetic changes and clinical features for 102 primary acute lymphoblastic leukemia（ALL）.【Methods】102 primary childhood ALL patients were immunophenotyped by flow cytometry as well as described as FAB classification.and 68 cases were subjected to karyotype analysis by G-binding technology.【Results】Of the 102 childhood patients,15.7%were identified as T-ALL and 84.3%as B-ALL.Myeloid antigen（MyAg） expression was documented in 35.3% of the cases analysed and CD13 was most commonly expressed in My＋-ALL as 27.8%.Among 88 patients,41cases were found abnormal karyotypes（51.3%）.The clinical and biological features of ALL patients among T-ALL and B-ALL showed that increased white blood count（WBC）（50×109/L）,more serious extramedullary infiltration were seen in T-ALL patients.【Conclusion】Our results indicated that immunophenotype did have great significance for morphological diagnosis and helped to understand the origin and differentiation period of blastic cells.This information would guide to estimate the risk of ALL patients and to choose appropriate protocol for better outcome.