成人急性淋巴细胞白血病髓系抗原和CD_(34)表达研究

Study on the expression of myeloid markers and CD 34 antigen in adult acute lymphoblastic leukemia

目的分析成人急性淋巴细胞白血病（ＡＬＬ）的髓系抗原、ＣＤ３４表达特点及与Ｐｈ染色体表达、预后的关系。方法采用间接免疫荧光法分析１０２例初治ＡＬＬ患者的免疫表型。结果①成人ＡＬＬ髓系抗原阳性率达２１．６％，其中ＣＤ３３阳性最常见（阳性率为１５．７％）。Ｔ系ＡＬＬ和Ｂ系ＡＬＬ髓系抗原表达差异无显著性。ＡＬＬＬ２中的阳性率高于Ｌ１（Ｐ＝０．０５）。在Ｂ系ＡＬＬ中随细胞分化成熟阳性率逐渐降低。②ＣＤ３４表达阳性率为５３．６％，ＢＡＬＬ阳性率高于ＴＡＬＬ（Ｐ＜０．０１）；ＢＡＬＬ中前Ｂ祖细胞型明显高于普通型、前Ｂ细胞型和成熟Ｂ细胞型，与髓系抗原的表达无关。③髓系抗原阳性病例完全缓解（ＣＲ）率明显低于阴性病例（Ｐ＜０．０２５）；ＣＤ３４表达和治疗缓解率无显著相关性。二者均与治疗达缓解的时间无关。④Ｐｈ染色体和（或）ｂｃｒ／ａｂｌ融合基因阳性率为３５．９％，阳性病例ＣＲ率明显低于阴性病例（Ｐ＜０．０２５）。⑤髓系抗原和ＣＤ３４表达均与患者年龄、治疗前白细胞计数、肝脾肿大情况无关。结论成人ＡＬＬ髓系抗原表达和ＦＡＢ分型有关，与治疗缓解率呈负相关；ＣＤ３４表达与ＡＬＬ亚型、细胞分化程度有关，和治疗缓解率无显著关系。Ｐ?

Objective To analyse the expression of myeloid markers and CD 34 antigen on lymphoblasts in adult ALL and its relationship with prognosis.Method Immunophenotypes were examined using indirect immunofluorescence method in 102 de novo ALL. Results The incidence of myeloid antigen expression in adult ALL was 21.6% and the commonest one was CD 33 (15.7%). There was a higher incidence of myeloid antigens expression in ALL L 2 than in ALL L 1 (25.6% vs 5.3%, P=0.05).CD 34 was expressed in lymphoblasts from 30 of 56 patients (53.6%).Incidence of CD 34 expression in B ALL was higher than that in T ALL (61.7% vs 11.1%, P<0.01). No relationship between CD 34 ,myeloid antigens and cell maturity was found within B ALL.There was no relation between expression of myeloid antigens and CD 34 . The CR rate in My + ALL was lower than that in My - ALL (52.6% vs 80.0%, P<0 025),and was no relation with CD 34 expression.In addition, Ph chromosome and/or bcr/abl fusion gene was positive in 35.9% of the patients,and CR rate of Ph positive patients was higher than that in Ph negative patients. Conclusion Expression of myeloid antigens was related to FAB subtype and cell maturity in adult ALL. There was no relationship between myeloid antigen expression and CR rate. A higher incidence of CD 34 expression was found in Pro B ALL than in common ALL and Pre B ALL. Expression of CD 34 had no relation with CR rate.