累及单核细胞系急性白血病的免疫表型和遗传学研究

Study on cytogenetics and immunophenotype of acute myelomonocytic and monocytic leukemia

目的 探讨急性髓系白血病-M4、M5亚型的细胞遗传学、免疫表型特征。方法 应用染色体G显带、间期荧光原位杂交技术和流式细胞术对30例M4、M5患者进行遗传学分析和免疫表型检测。结果 染色体分析:30例M4、M5中共发现13例伴有11q2 3染色体异常,总发生率为4 3 3% ,其中M5a 1例、M5b 8例、M4b 4例,异常核型有6种:t (11;19) 4例;t(11;17) 2例;t(9;11) 2例;t(10 ;11) 1例;t(6 ;11) 1例;t(11;?) (q2 3;?) 1例;del(11)(q2 3) 2例。I-FISH检测MLL基因异常共13例阳性,其中M5 8例,M4 5例。免疫表型检测各种抗原阳性率依次为HLADR(92 % ) ,CD33(92 % ) ,CD6 4 (85 % ) ,CD11b(80 % ) ,CD15 (79% ) ,CD117(79% ) ,CD13(6 9% ) ,CD34(6 1% ) ,CD5 6 (38 5 % ) ,CD14 (31% ) ,CD3(14 % ) ,CD2 (7% ) ,CD7(7% )。结论 11q2 3异常在AML -M5 /M4中发生率高,该组患者高表达早期干祖细胞标志CD34、CD117、HLA -DR ,具有独特的遗传学、免疫学特点。

Objective To study the cytogenetic and immunophenotype features in acute monocytic leukemia(M5) and acute myelomonocytic leukemia(M4). Methods Thirty cases of AML-M4 and AML-M5 were studied in genetics by the G-banding techniqne, interphase fluorescence in situ hybridization (I-FISH) and flow cytometry immunophenotyping. Results 11q23 abnormalities were found in 13 of 30 cases with M4 and M5. The incidence of 11q23 abnormalities was 43.3%, including 9 cases with M5(M5a, one; M5b, eight) and 5 cases with M4. Karyotype analysis showed following abnormalities: t(11;19)(4 cases), t(11;17)(2 cases), t(9;11)(2 cases), t(10;11)(1 case), t(6;11)(1 case), t(11;?)(q23;?)(1 case) and del(11)(q23)(2 cases). MLL genes abnormalities were found by FISH analysis in thirteen cases including 8 cases with M5 and 5 cases with M4. Immunophenotyping(positivity) induded HLADR(92%),CD33(92%),CD64(85%),CD11b(80%),CD15(79%),CD117(79%),CD13(69%),CD34(61%),CD56(38.5%),CD14( 31%),CD3(14%),CD2(7%) and CD7(7%). Conclusion There is high incidence of 11q23 abnormalities in AML-M5 / M4, and the stem cell marker CD34, CD117 and HLA-DR are highly expressed, representing unique cytogenetic and immunophenotypic features.