双表型急性白血病的免疫分型特征及预后分析

The immunophenotyping and the prognosis of Biphenotypic Acute Leukemia

目的探讨双表型急性白血病的免疫分型特点及其疗效分析。方法采用流式细胞术四色免疫荧光直接标记技术与CD45/SSC设门分析技术检测53例双表型急性白血病患者,根据欧洲白血病免疫分类组(EGIL)积分标准进行免疫学分型。结果 53例患者中My+B-ALL 43例,均共同表达cCD79a和cMPO,胞膜抗原CD19、CD10表达量较高;My+T-ALL 6例,均共同表达cCD3和cMPO,胞膜CD7、CD5表达量较高;T系和B系抗原共同表达者3例,均共同表达cCD3和cCD79a;髓系、T系和B系抗原共同表达者1例。对CD34+患者,My+的B-ALL和T-ALL的完全缓解(CR)率均低于同期My-的患者。结论流式细胞术是诊断双表型急性白血病极为特异的方法。双表型急性白血病以My+B-ALL系抗原共同表达最为常见,其次是My+T-ALL。cCD3、cCD79a、cMPO对诊断及鉴别双表型急性白血病极为特异。低分化细胞临床疗效不佳。

Objective To analyze the characteristic immunophenotyping and prognosis of Biphenotypic Acute Leukemia（BAL）. Methods Four-color direct immunofluorescence staining methods of flow cytometry and use of CD45/SSC gating analysis,immunophenotype of antibody integration system were used for detection of 53 doubtful cases of Biphenotypic Acute Leukemia. Results Forty-three My＋ B-ALL of 53 cases showed cCD79a and cMPO immunophenotyping,membrane antigen CD19 and CD10 higher; 6 cases of My＋ T-ALL showed cCD3 and cMPO,cell film CD7 and CD5 higher;3 cases of T/B showed cCD3 and cCD79a, only one case was the T/B/My common expression. Concerning CD34＋ patients,complete remission rate on My＋ B-ALL and T-ALL patients had stayed below compared to homeochronous My B-ALL and T-ALL ones. Conclusion Flow cytometry is a very specific method of diagnosis of BAL. BAL with My/B-ALL expressed is the most common, the next is My/T-ALL,and cCD3, cCD79a and cMPO are specific in diagnosis and differential diagnosis of the BAL. The low CR rate was found in the low differentiated cells in BAL.