慢性髓系白血病急变期与急性白血病免疫表型的比较研究

Comparative Study of the Immunophenotype of Chronic Myeloid Leukemia in Blast Crisis and Acute Leukemia

目的比较慢性髓系白血病急变期(CML-BC)与急性白血病(AL)的免疫表型特征。方法采用一组单克隆抗体和四色流式细胞术对58例成人CML-BC及同期420例AL患者骨髓标本进行免疫表型分析。结果58例CML-BC中,CML-AML占77.6%,CML-ALL占13.8%,CML-MAL(混合性白血病)占5.2%;AL中,AML占66.2%,ALL占32.9%,MAL占1.0%。CML-AML中,CD7及CD34表达高于AML;CML-BC和CML-AML中CD7与CD34共阳性表达分别高于AL和AML(P<0.05)。276例AML中,纯型占62.3%,变异型占37.7%;130例ALL中,纯型占44.6%,变异型占55.4%;42例CML-AML中,纯型占59.5%,变异型占40.5%;8例CML-ALL中,纯型与变异型各占50.0%。结论CML-BC中干祖细胞阶段的抗原较AL高表达,变异型CML-BC与AL比例相当。

Objective To compare the immunophenotypic features of chronic myeloid leukemia （CML） in blast crisis and acute leukemia（AL）. Methods Immunophenotypic analysis was performed using a panel of monoclonal antibodies and four-color immunofluorescence staining methods of flow cytometry in 58 patients with CML-BCLL and 420 patients with AL during the same period. Results 77.6% of the CML-BC patients were AML transformation, 13.8% was ALL transformation and 5.2% was MAL （mixed lineage acute leukemia） transformation. In AL, 66k 2 % of the patients were AML, 32.9 % was ALL and 1.0 % was MAL. In CML-AML, CD34 and CD7 positivity was higher than that in AL. Coexpression of CD7 and CD34 was more frequent in CML-BC and CML-AML than that in AL and AML（P 〈 0.05） respectively. In 276 AMLcases, the pure phenotype accounted for 62.3 % and variant type 37.7 %. In 130 ALLcases, the pure phenotype accounted for 44.6 % and variant type 55.4 %. The pure and variant type accounted for 59.5 % and 40.5 % in 42 cases of CML-AML, 50.0% and 50.0% in 8 cases of CML-ALL. Conclusions The present study suggests that the hematopoietic precursor antigen is more frequent in CML-BC than that in AL. The variant type is proper in CML-BC and AL.