小儿急性白血病免疫表型和骨髓细胞DNA含量测定的临床意义

Clinical Significance of Myelocytic DNA Content Immunophenotype in Children with Acute Leukemia

目的 分析小儿急性白血病 (AL)的免疫表型、异倍体、细胞周期分布状况的临床意义。方法 应用流式细胞仪检测了 4 2例初诊为AL患儿的免疫表型及骨髓单个核细胞 (MNC)的DNA含量。结果 B -ALL明显多于T -ALL ,髓系抗原在ANLL组中的表达率依次为CD3 3 >CD13 >CD14>CD15 。 4例AL同时表达了淋系和髓系的抗原 ,预后差。AL患儿骨髓细胞周期的S期细胞比例 (S % )明显低于正常对照 ,说明AL患儿白血病细胞的增殖能力低下。ALL组中 ,亚倍体的S %均值与超二倍体、二倍体比较存在显著差异性 ,ANLL组中 ,CD3 3/CD13<1者的S %均值与CD3 3 /CD13 >1者比较亦存在显著差异。结论 AL患儿的免疫表型、倍体关系、细胞周期及其之间的关系 ,对临床诊断、治疗、预后判断具有重要指导意义。

Objective To analyse the clinical significance of the immunophenotype, aneuploidy and cell circle distribution in children with acute leukemia (AL). Methods With the techniques of flow cytometry (FCM), the immunophenotype and the DNA content in bone marrow mononuclear cells were determined in 42 cases of confirmed AL patients. Results The expression frequency of myeloid antigens in the ANLL group was CD 33 >CD 13 >CD 14 >CD 15 . Both lymphoid and myeloid antigen were expressed in the 4 AL patients with poor prognosis. The percentage of myelocytic circles (S%) in AL patients was significantly lower than in normal controls, indicating hemopoietic hypofunction in AL patients. The S% medium of hypodiploidy in the ALL group was significantly different compared with that of hypodiploidy and diploidy in the ALL group. The S% medium in patients with CD 33 /CD 13 >1 was marked different compared with those with CD 33 /CD 13 <1 in the ANLL group. Conclusions The analysis of immunophenotype, aneuploidy, and cell circle plays an important role in clinical diagnosis, treatment and prognosis.