高白细胞性急性淋巴细胞白血病临床特征及免疫表型研究

A research for clinical feature and immunophenotype characteristics of hyperleukocytic acute lymphoblastic leukemia

目的探讨高白细胞急性淋巴细胞白血病(HLALL)的临床特征及免疫表型特点。方法使用流式细胞术对19例HLALL和76例非高白细胞急性淋巴细胞白血病(NHLALL)进行免疫表型检测,并对结果进行分析。结果与NHLALL相比HLALL的发病年龄较大(t=2.2479,P<0.01),骨髓增生更为活跃(u=4.22,P<0.01),肝、脾浸润更为明显(χ2=18.280、4.222,P<0.05),缓解率低(χ2=7.675,P<0.05),HLALL多系列抗原的共表达与NHLALL比较发生率更高(χ2=4.667,P<0.05),在HLALL中出现最多的髓系抗原是CD13,与HLALL比较差异有统计学意义(χ2=5.296,P<0.05)。结论 HLALL的发生与年龄,骨髓增生程度,多系列抗原,特别是CD13的共表达有关。肝、脾浸润更为明显,预后不良。

Objective To investigate the immunophenotype characteristics and clinical feature of hyperleukocytic acute lymphoblastic leukemia （HLALL）. Methods Immunophenotyping was detected in 19 HLALL and 76 NHLALL patients by flow cytometry, then the result and its clinical feature were analyzed. Results The results showed that as compared with NHLALL group, the age of onset in HLALL group was older （ t = 2. 2479, P 〈 0.01 ）, the proliferation of bone marrow was more active （ u = 4.22, P 〈 0.01 ）, the infiltration of liver and spleen was more obvious（ x2 = 18. 280,4. 222, P 〈 0.05 ） , the remission rate was lower（ X2 = 7. 675, P 〈 0. 05 ） ,the cross expressing positive rate of different lineage associated antigens was higher （x2 = 4. 667, P 〈 0. 05 ）. The most myeloid lineage associated antigen in HLALL group was CD13, the significant difference with that in NHLALL group had statistical significance （ X2 = 5. 296, P 〈 0.05 ）. Conclusion The happening of HLALL has relationship with age, the proliferation degree of bone marrow, the cross expressing of different lineage associated antigens especially CD13. The infiltration of liver and spleen is more obvious in HLALL group than that in NHLALL,and the prognosis is unfavourahle.