伴髓系抗原表达的高危儿童急淋白血病临床生物学特征及长期预后分析

Clinical,biological and long-term prognostic analysis in high-risk childhood ALL with myeloid antigen expression

目的分析髓系抗原阳性(My+)的儿童高危急性淋巴细胞白血病(ALL)的临床生物学特征及长期预后关系。方法采用流式细胞仪直接免疫荧光法及RT-PCR法分别检测2001年8月至2003年3月在我院收治的初诊高危112例ALL患儿的髓系抗原及融合基因的表达,对其预后进行了中位时间达76个月的长期观察。结果髓系抗原的表达率为30.4%,B系ALL表达髓系抗原多于T系ALL,差异有显著性意义(P=0.019)。My+ALL患儿携带TEL-AML1融合基因者多于My-ALL患儿(P=0.049),My+ALL与My-ALL患儿在临床特点以及疗效等方面两组之间差异无显著性意义。结论高危ALL无论有无髓系抗原的表达其疗效无显著性差异,髓系抗原阳性表达在高危儿童ALL时不能作为预后不良的因素。

Objective To observe myeloid antigen expression and its relationship with clinical and biological features as well as long-term prognosis in children with high-risk （HR） acute lymphoblastic leukemia （ALL）. Methods The expression of myeloid antigen and fusion gene of 112 children with HR-ALL from August of 2001 to March of 2003 were measured respectively by 3-color flow cytometry and RT-PCR, the impact of myeloid antigen expression on clinical prognosis were studied for a median time of 76 months. Results The total positive cases of myeloid antigen expression were 34 （30.4%）. Myeloid antigen expression in B-ALL group were significant higher than that in T-ALL group （P = 0. 019） ; TEL/ AML1 positive in My^＋ ALL group were more than in My^- ALL group （P =0. 049）. There were no significant differences between My^＋ ALL group and My^-ALL group in clinical features and treatment outcome. Conclusion Myeloid antigen expression is not an independent prognostic factor in HR-ALL patients.