Ly^＋-AML和Ly^--AML在FAB和WHO分型中的分布及治疗反应

Analysis on Ly^+-AML and Ly^--AML's distribution in FAB and WHO classification and therapeutic response

目的:探讨伴淋系抗原表达的急性髓细胞白血病(Ly+-AML)和不伴淋系抗原表达的急性髓细胞白血病(Ly--AML)在FAB和WHO分型中的分布和它们的治疗反应。方法:117例初发的成人急性髓细胞白血病(AML),用常规瑞氏染色及细胞化学染色对骨髓细胞进行FAB分型,采用白血病免疫分型欧洲协作组(EG IL)积分系统,用单克隆抗体标记,经流式细胞仪对骨髓细胞进行免疫分型。其中115例用G显带技术分析染色体核型,按WHO分型标准进行分型。每个病例用标准方案诱导缓解1个疗程后复查血液学缓解情况。结果:117例FAB分型为AML的病例中,免疫学分型为不伴淋系抗原表达的AML(Ly--AML)89(76.1%)例,伴淋系抗原表达的AML(Ly+-AML)28(23.9%)例。WHO分型中,AML伴有重现性染色体异常在Ly+-AML和Ly--AML的发生率分别为23.1%和50.5%(P=0.013)。用AML的标准诱导治疗方案1疗程后,Ly--AML患者完全缓解率(CR)69.7%,Ly+-AML患者CR率34.6%(P=0.001)。结论:白血病细胞免疫分型可客观反映细胞来源及分化阶段,经标准诱导缓解后,Ly--AML患者CR率高于Ly+-AML(P=0.001)。

Aim：To investigate distribution and therapeutic response of lymphoid surface antigen-positive acute myeloid leukemia （Ly ^＋ -AML） and lymphoid surface antigen-negative acute myeloid leukemia （Ly^--AML） in FAB and WHO classification. Methods： Bone marrow aspirates from 117 adult patients newly diagnosed de novo acute myeloid leukemia （AML） were analyzed. through standard morphologic examination and cytochemical analysis by the The diagnosis was made French-American-British（FAB） Cooperative Study Group and through immunophenotyping with a panel of monoclonal antibodies against myeloid- and lymphoid-associated antigens by European Group of International Leukemia （EGIL） scoring system. All chromosome karyotypes were analyzed through G-Band technique. 115 of those cases were typed by a new World Health Organization （WHO） classification of haematological malignancies After all patients were treated with a standard remission induction regimen for 1 course, their Bone marrow aspirates were Wrigth-Gimsa-stained and the therapeutic effect was analyzed. Results： According to FAB criteria, 117 cases were classified as acute myeloid leukemia. After immunologic phenotyping, 89 cases（76.1% ） were classified as Ly^--AML. 28 cases（23.9% ） were classified as Ly^＋ -AML. Of WHO typing,23.1% of Ly^＋ -AML cases was AML with recurrent genetic abnormalities. The patients with Ly^-- AML had a significantly higher incidence of these karyotypic abnormalities compared with Ly^＋ -AML （50. 5% v 23. 1%, P = 0. 013）. After induction therapy, Complete remission （CR） rate of Ly^--AML and Ly ^＋ -AML was 69.7% and 34.6% respectively（P = 0. 001 ）. Conclusion：Leukemic cell immunotyping can reflect the cell origin and differentiation stage objectively. After induction therapy, CR rate of Ly^- -AML was higher than that of Ly^＋ -AML （P =0. 001 ）.