急性粒细胞白血病患儿免疫表型及其临床意义

Immunophenotype of Children with Acute Myeloid Leukemia and Its Clinical Significance

目的探讨儿童急性粒细胞白血病(AML)免疫分型及其临床意义。方法总结81例儿童AML的免疫表型与FAB分类、1个月骨髓缓解(CR)率及3年无病生存(EFS)率的关系。结果AML儿童1个月CR率为71.6%,3年EFS率为50.8%。HLA-DR缺失,CD34缺失主要见于急性早幼粒细胞白血病(M3)型,阴性患儿CR、EFS率明显高于阳性患儿。CD13阳性患儿的CR明显高于缺失患儿。CD33缺失在M2型中多见,特别是ETO阳性患儿。除外M3病例后分析,CD33缺失患儿的CR率明显高于阳性患者。淋系抗原表达率占34.6%,其中CD7阳性者CR率、EFS率均低于对照组,但无统计学差异。CD56与FAB分型中M2型有显著相关性,其CR率、EFS率均低于对照组。结论HLA-DR、CD34缺失主要见于M3型,是预后良好的指标。CD33缺失多见于M2型中ETO阳性患儿,预后好。淋系抗原、CD56表达多见于M2型,可能是预后差的指标。

Objective To explore the immunophenotype of children with acute myeloid leukemia（AML） and its clinical significance.Methods Statistics was used to analyze the relationship between the immunophenotype of AML and their French-American-Britain（FAB） classification,complete remission （CR） in one month and 3-years event-free survival（EFS）.Results CR rate was 71.6% and 3-years EFS rate was 50.8%. HLA-DR and CD34 absent mainly in M3, associated with higher CR and EFS rate. So did CD33 negative cases, especially in M2. CD13 positive was significantly predictive factor for achieving CR.Co-expression of lymphoid antigens and NK cell antigens（CD56） with M2 which correlated with lower CR and EFS rate.Conclusions The negative of HLA-DR, CD34, CD33,as well as CD13 positive, have relationship with good prognosis. Lymphoid antigens and CD56 are poor prognostic factors.