12例经流式细胞仪确诊的急性混合型白血病分析

Analysis of 12 cases of mixed-lineage acute leukemia diagnosed by flow cytometry

目的:对比经流式细胞仪(FCM)确诊的急性混合型白血病(MAL)与经骨髓细胞形态学组化染色发现具有急性混合型白血病特性的急性白血病(AL)患者的符合率。方法:选取12例MAL患者,经FCM确诊,对比其相应的骨髓细胞学组化染色FAB分型结果,并计算经形态学和免疫组化发现MAL特性的AL患者占经FCM确诊MAL患者的百分率。结果:经FCM确诊的MAL患者,其中急性双表型白血病8例,急性双克隆型白血病3例,发现急性细胞系转变型1例。此12例AL患者经骨髓细胞学组化染色确诊7例为急性淋巴细胞白血病(ALL),3例为急性髓系白血病(AML),另2例经细胞形态学未确诊的AL患者中,1例多次细胞形态学显示呈骨髓坏死,但最终FCM技术也确诊为MAL。结论:经骨髓细胞形态学及组化染色发现具有MAL表现的AL患者仅占经FCM确诊的MAL患者的17%,误诊率极高。应重视流式细胞仪免疫分型在MAL诊断中的应用。

Objective：To compare the coincidence of the mixed--lineage acute leukemia（MAL） diagnosed by flow cytometry （FCM） and by the bone marrow morphology and histochemical stain. Methods：To choose 12 cases of MAL patients diagnosed by FCM, and compare the corresponding FAB type results by histochemical stain. Then calculate the percent of MAL diagnosed by histochemical stain. Results：The 12 cases of MAL patients diagnosed by FCM, including 8 cases of biphenotypic acute Leukemia, 3 cases of double clone leukemia and 1 case of cell line switched leukemia. Within these 12 cases of leukemia patients, 7 of them were diagnosed as ALL by the bone marrow morphology and histochemical stain, 3 of them as AML, and another 2 of them were not diagnosed by morphology, one of them was bone marrow necrosis and diagnosed as MAL finally by FCM. Conclusion：Only 17 percent of MAL diagnosed by FCM has the characteristic of MAL diagnosed by the bone marrow morphology and histochemical stain, the misdiagnosis rate is high. the application of FCM should be emphasized.