9例Ph染色体阳性成人急性淋巴细胞白血病的临床和实验研究

ANALYSIS OF NINE CASES OF PHILADELPHIACHROMOSOMEPOSITIVE ADULT ACUTELYMPHOBLASTIC LEUKEMIA

报道９例Ｐｈ染色体阳性的急性淋巴细胞白血病（Ｐｂ￣－ＡＬＬ）的临床和实验研究结果。Ｐｈ￣－ＡＬＬ占同期研究的３１例成人ＡＬＬ的２９％。其中４例Ｐｈ染色体与正常核型嵌合，３例合并＋１７。病情完全缓解后２例Ｐｈ染色体消失，１例其百分比显著降低。免疫表型检测８例为Ｂ系列ＡＬＬ。以、为主要表型，同时有ＣＤ＿２和ＣＤ＿（３４）的高表达。１例病程中转变为杂合性急性白血病。上述免疫表型特点反映Ｐｈ￣＋ＡＬＬ的恶性细胞起源于早期定向或多能干细胞。该组患者白细胞计数较高，治疗反应差，提示Ｐｈ￣＋ＡＬＬ为一预后不良的特殊亚型，治疗上应有别于ＰｈＡＬＬ。

he nine cases of Philadelphia chromosomepositive adult acute lymphoblastic leukemia (Ph￣+ ALL) accounted for 29% of the total 31 cases of cases of adultAI.L in the same period. Four of the nine cases of Ph+ALL were characterized by the mosaicism of Ph chromosome and normal karyotypes. After achieving com-plete remission, two cases became Ph and 18% Ph￣+cells remained in another case. Eight of the nine casesof Ph+ ALL were diagnosed as Blineage expressingmainly CD,_(10)CD_(19) and CD_(22) They also showed high expression of CD_2 and CD_(34) antigens. One case trans-formed into hybrid acute leukemia. High white bloodcell count and poor response to treatment in this groupof patients indicated that Ph￣+ ALL was a poor prognostic subtype and should be treated differently fromPh ALL.