髓系抗原阳性儿童急性淋巴细胞白血病的临床及实验室分析

Clinical and Experimental Analysis of Myeloid Antigen Positive Childhood Acute Lymphoblastic Leukemia

采用一组系列相关单克隆抗体和流式细胞术间接免疫荧光法分析 85例初治儿童急性淋巴细胞白血病 (ALL)患者的免疫表型 ,观察儿童ALL髓系抗原表达及其与临床和生物学特性的关系。研究结果表明 ,儿童ALL髓系抗原阳性率达 2 1.2 % ,以CD13和CD33阳性常见。T系ALL与B系ALL髓系抗原表达无差异 (P >0 .75 )。T/B混合ALL中髓系抗原表达率较高 (7例中 3例阳性 )。ALL L2 与ALL L1髓系抗原表达无差异 (P >0 .0 5 ) ;髓系抗原阳性ALL与髓系抗原阴性ALL临床生物学特征、染色体数量及其结构变化均无差异 (P >0 .2 5 ) ;髓系抗原阳性病例完全缓解 (CR)率低于阴性病例 ,1年内复发率高于阴性病例 ,但均无差异 (P >0 .0 5 )。结论提示 ,儿童ALL髓系抗原表达与治疗缓解率无关 ;T/B混合ALL的髓系抗原的表达较高 。

The purpose of this investigation was to study the myeloid antigen expression and its relationship with clinical and biological features in children with acute lymphoblastic leukemia(ALL). A panel of lineage-associated monoclonal antibodies and indirect immunofluorescence technique were used to analyse the immunophenotype in 85 previously untreated cases. The results showed that twenty-one point two percent of patients expressed myeloid antigens(My +), and CD13 and CD33 were frequently involved. The incidence of myeloid antigen expression had no statistical difference between T and B ALL or between ALL-L 1 and ALL-L 2(P>0.05). Myeloid antigens were expressed in three of seven T/B mixed ALL cases. There was no significant difference in clinical and biological features and chromosome abnormality between My + and My - cases(P> 0.25). There was no significant difference in complete remission rate and relapse rate between My + and My - cases(P>0.05). The conclusion suggested that myeloid antigen expression was not associated with complete remission rate in childhood ALL. T/B mixed ALL more frequently showed expression of myeloid antigens and had an unfavorable prognosis.