不同年龄成年人急性白血病形态学、免疫学及细胞遗传学分型比较

Comparison of morphology, immunology and cytogeneties in adult acute leukemia of different ages

目的 探讨不同年龄成年人急性白血病（AL）的形态学、免疫学及细胞遗传学（MIC）特征.方法 172例初诊AL成年患者按年龄分为两组：非老年组（年龄＜60岁）及老年组（年龄≥60岁）,进行MIC分型比较.结果 老年组中M3的比例显著低于非老年组16.0%（3/50）：18.9%（23/122）]（P＜0.05）.老年组骨髓增生低下或极度低下的比例显著高于非老年组[14.0%（7/50）：4.1%（5/122）]（P＜0.05）,而增生明显至极度活跃的比例显著低于非老年组[52.0%（26/50）：73.8%（90/122）]（P＜0.05）.老年组急性髓细胞白血病（AML）患者中,伴淋系抗原表达的AML（Ly＋AML）比例显著高于非老年组[63.4%（26/41）：41.3%（38/92）]（P＜0.05）.老年组AML患者中,高危组核型比例显著高于非老年组[33.3%（11/33）：14.1%（10/71）]（P＜0.05）.结论 年龄是AL的重要预后因素,老年AL患者的预后总体较非老年AL患者为差.

Objective To investigate the characters of morphology,immunology and cytogenetics of adult acute leukemia （AL） in different ages. Methods 172 cases of newly diagnosed adult AL were divided into two groups：the non-aged group （age〈60 years） and the aged group （ age≥60 years）. Morphology,immunology and cytogenetics between the two groups were compared. Results The incidence of M3 in aged AL was significantly lower than that in non-aged AL[6.0 %（3/50） vs 18.9 %（23/122）,P 〈0.05]. The incidence of hypo-or extremely hypo-cellular AL in aged AL was significantly higher than that in non-aged AL[14.0 %（7/50） vs 4.1 %（5/122）,P 〈0.05],but the incidence of hyper-or extremely hyper-cellular was significantly lower than that in non-aged AL[52.0 %（26/50） vs 73.8 %（90/122）,P 〈0.05]. Among aged acute myeloid leukemia （AML）,the incidence of lymphoid antigen positive AML （Ly＋AML） was significantly higher than that in non-aged AML[63.4 %（26/41） vs 41.3 %（38/92）,P 〈0.05]. The incidence of adverse karyotypes in aged AML was significantly higher than that in non-aged AML[33.3 %（11/33） vs 14.1 %（10/71）,P 〈0.05].Conclusion Age is an important prognostic factor in AL. Generally,aged AL has poorer prognosis than nonaged AL.