表达CD7抗原的成人急性髓性白血病

CD7 positive adult acute myelocytic leukemia

目的：探讨表达ＣＤ７抗原的急性髓性白血病（ａｃｕｔｅｍｙｅｌｏｃｙｔｉｃｌｅｕｋｅｍｉａ，ＡＭＬ）患者的临床特征、免疫表型及细胞遗传学特征。方法：选择１９９２年８月至１９９６年９月在我院住院治疗的成人ＡＭＬ患者９９例，采用间接免疫荧光法及Ｇ显带进行免疫表型及染色体核型分析，治疗采用我院常规化疗方案。结果：１２例（１２．１２％）ＡＭＬ患者表达ＣＤ７抗原，其中１１例（１１／１２）同时表达ＨＬＡＤＲ；受检的８例患者（１００％）皆同时表达ＣＤ３８；骨髓染色体分析，３例异常，可见－７，１７ｐ＋，９ｑ＋，５ｑ－，＋８及ｔ（８；２１）。此外，肝肿大者６例（６／１２），完全缓解（ｃｏｍｐｌｅｔｅｒｅｍｉｓｓｉｏｎ，ＣＲ）者５例（５／１２），与ＣＤ７－组比较差异有统计学意义。结论：ＣＤ７＋ＡＭＬ多同时表达ＨＬＡＤＲ、ＣＤ３８，染色体核型无特征性异常，肝肿大发生率高，ＣＲ率低。

Objective: To discuss clinical, immunophenotypic and karyotypic characteristics of acute myelocytic leukemia (AML) with expression of CD7 antigen. Methods: 99 patients of AML enrolled in our hospital from August 1992 to September 1996 were selected. Indirect immunofluorescence method and G band method were used to analyze the immunophenotypic and karyotypic characteristics of patients. Routine chemotherapeutic regimen was used for treatment. Results: 12 cases (12.12%) expressed CD7. Among them, 11 of 12 cases expressed HLA DR and 8 of 8 cases expressed CD38. Abnormal karyotypes were found in 3 cases with -7, 17p+ , 9q+, 5q-, +8, t(8;21). In addition, 6 cases (6/12) were found to have hepatomegaly and 5 cases (5/12) achieved complete remission (CR). There was significant difference compared with CD7 - AML. Conclusion: CD7 + AML always expressed HLA DR and CD38. No particular karyotypic abnormality was identified in CD7 + AML. The incidence of hepatomegaly was higher and CR rate lower in CD7 + AML than in CD7 - AML. Our results suggest that CD7 expression on AML cells can be regarded as a prognostic risk factor in AML.