CD20阳性成人急性B淋巴细胞白血病患者临床特点及生存分析

Clinical Features and Survival Analysis of Patients with CD20 Positive Adult B-lineage Acute Lymphoblastic Leukemia

本研究分析成人CD20阳性急性B淋巴细胞白血病(B-lineage acute lymphoblastic leukemia,B-ALL)患者的临床特点和生存情况。回顾性总结分析郑州大学第一附属医院血液科2004年5月至2008年12月收治的119例成人B-ALL患者的临床特点和生存情况。结果表明:119例成人B-ALL中CD20阳性40例(33.61%),CD20阴性者79例(66.39%),CD20阳性组和CD20阴性组男性患者比例分别为72.50%和50.63%(p<0.05),CD20阳性组和CD20阴性组发病时外周血白细胞数分别为(27.35±30.29)×109/L和(50.11±81.72)×109/L(p<0.05)。两组患者在年龄分布、肝脾、淋巴结和中枢神经系统浸润、发病时血红蛋白和血小板水平、髓系抗原表达、Ph染色体、超二倍体和正常核型比例、4周内完全缓解率、诱导死亡率和复发率方面的差异无统计学意义(p>0.05);Kaplan-Meier曲线生存率分析显示,CD20阳性组和CD20阴性组成人B-Lin ALL的中位总体生存(OS)时间分别为11.0个月和12.0个月,3年总生存率分别为28%和20%,两组间差异无统计学意义(p=0.832)。结论:CD20在成人B-ALL中的表达与患者的性别分布、外周血白细胞数相关,与其它临床特点无显著相关性,对患者的预后无显著影响。

The aim of this study was to explore the clinical features and survival of adult patients with CD20 positive B-lineage acute lymphoblastic leukemia （B-ALL）. The clinical manifestations, examination results, therapeutic effect and survival rate of 119 adult B-ALL patients diagnosed and treated in our hospitcl from May 2004 to Jannary 2008 were analyzed retrospectively. The results showed that among 119 cases, CD20 positive B-ALL accounted for 40 cases （33.61%）, CD20 negative B-ALL patents accounted for 79 cases （66.39）, the percentage of male patients in CD20 pasitive and negative groups were 72.50% and 50.63% , the leukocyte counts at diagnosis in these two groups were （27.35 ± 30.29） ×10^9/L and （0.1 1±81.72） × 10^9/L, respectively, there were significant differences （p 〈 0.05 ）, wherears the distribution of age, infiltration of liver, spleen, lymph nodes and central nervous system, the hemoglobin and platelet levels, the expression of myeloid lineage marker, the incidence of Ph chromosome, the ratio of hyperdiploid and nornal karyotype, the complete remission rate within 4 weeks, induction death rate and relapse rate and so on in CD20 positive and negative groups showed no significant differences （p 〉 0.05 ）. The analysis of Kaplan-Meier curve on survival rate demonstrated that the median overall survival time and 3-year overall survival rate of adult B-ALL patients in CD20 prositive and negative groups were 11.0 months and 12.0 months, 28% and 20% respectively, there were no statistical differences （ p = 0. 832）. It is concluded that the expression of CD20 in adult B-ALL appears to be associated with sex and leukocyte count, but not associated with other clinical features, which indicates no significant influence on the prognosis of patients.