摘要
本文应用APAAP方法对27例成人急性淋巴细胞性白血病患者进行免疫分型。结果:早前B—ALL 9例、普通型12例、前B—ALL 3例、未见B—ALL、前T—ALL 2例、T—ALL 1例,并对其进行了临床分析,半数以上的早前B—ALL首次缓解的平均时间为56天,平均生存缓解期(MRD)19.5月,6例死亡者平均生存期14月,多数普通型取得缓解的平均时间为42天,MRD 27.4月,6例死亡者平均生存期为18.5月,前B型仅1例缓解,后复发,平均生存期8.4月,2例前T型缓解后均复发,生存期为3.5和8个月,1例T—ALL 26天缓解,至今持续28个月。我们发现Null型、前B型、混合型ALL和同时伴有不利的预后因素者治疗反应差。结论;成人急淋的免疫分型与临床表现、治疗反应、缓解率和生存期密切相关。
27 cases of adult lymphoblastic leukemia(ALL) were classified with monoclonal antibodies by
alkaline phosphatase and monoclonal anti--alkaline phosphatase technique (APAAP). 9 cases were defined as early pre B--ALL, 12 cases as pre T--ALL and one cases as T--ALL. The mean duration
attaining first complete remission (CR) was 56 days in more than half of the early pre B--ALL cases
and the median remission duration was 19. 5 momths, 6 cases of early pre B--ALL died with the
median survival time of 14 months. The mean duration attaining first CR was 42 days in most of the
CALL cases and MRD was 27. 4 months. 6 cases of CALL died with the median survival time of 18. 5
months. One case of pre B--ALL relapsed after achieving CR. 3 cases of pre B--ALL died with the
median survival time of 8. 4 months. 2 cases of pre T--ALL relapsed after attaining CR,the survival
time was 3. 5 and 8 months respectively. One case of T--ALL acheived CR within one month. CR
sustained for 28 months until now. We found the poor prognosis associated with Null--ALL,pre B--
ALL, mixed ALL and adverse prognostic factors. The results suggested that the immunologic subtye of
adult All was related with clinical manifestation, response of therapy, remission rate and survival
duration.
