急性单核细胞白血病M_(5a)和M_(5b)的免疫表型和临床表现比较分析(英文)

Comparison of Immunophenotype and Clinical Manifestations between patients with M_(5a) and M_(5b) of Acute Monocytic Leukemia

急性单核细胞白血病(AML-M5)是一类具有独特生物学和临床特征的急性髓细胞白血病。为了调查急性单核细胞白血病(AML-M5)中M5a和M5b两亚型的免疫表型特征和临床行为及其相互关系。采用流式细胞术免疫荧光标记法对我院58例成人初发急性单核细胞白血病(AML-M5)细胞进行免疫表型检测,同时对其临床资料进行回顾性分析。结果表明虽然不同患者单核白血病细胞的免疫表型呈现一定的异质性,但CD68和CD11b在M5a中的表达高于M5b(P<0.01);M5a和M5b患者的性别、髓外浸润、外周血白细胞数、完全缓解率和无病生存率(>300天)无明显差异(P>0.05)。结论M5a和M5b似乎有着各自较独特的免疫表型特征,CD68与CD11b的表达在M5a更高,但在目前可用的治疗手段下M5a和M5b两组患者的完全缓解率和无病生存率并无差别。

Acute monocytic leukemia is a distinct subtype of acute myeloid leukemia（AML） with characteristic biology and clinical features. This study was designed to compare the immunophenotypical features and clinical manifestations of the patients with AML-M5a to that of patients with AML-M5b, and to identify differences between M5a and M5b and to explore their relations. A total of 58 cases of de novo adult patients with AML M5 were investigated. Immunofluoresence analysis by flow cytometry was performed to determine the immunophenotype of the leukemic cells in all cases. Meanwhile, clinical data of these cases were studied retrospectively. The results showed that the immunophenotypes of monocytic leukemic cells in patients with AML M5 were heterogeneous, and CD68 and CD1 lb were expressed higher in patients with AML M5a, compared with that in patients with AML M5b （ P 〈 0.01 ）. The significant differences in sex, extramedullary infiltration, WBC counts of peripheral blood, complete remission rate and disease-free survival （DFS 〉 300 days）between the patients with AML M5a and M5b did not exist（ P 〉0.05 ）. It is concluded that the special individual immunophenotype features can be detected in patients with either of AML M5a or M5b, and that expressions of CD68 and CD1 lb were much higher in M5a. It seems that the complete remission rate and disease-free survival of patients with Ms, and M5b are not different from that of currently available therapy.