CD56^+急性髓系白血病血液学特征及其临床意义

Clinical significance and hematologic features of CD56^+ acute myeloid leukemia

目的 :研究CD5 6 +急性髓系白血病 (AML)血液学特征及临床意义。方法 :流式细胞计数仪检测白血病细胞分化抗原的表达 ;RT PCR检测EBV mRNA ;电镜及免疫电镜观察超微结构 ;回顾性分析初诊时血液学特点、临床表现及对化疗的反应。结果 :CD5 6表达率为 30 .6 2 %(79 2 5 8) ;CD5 6 +AML中未见EBV感染 ;电镜及免疫电镜发现CD5 6 +AML细胞核中存在 1— 2团絮状结构 ;CD5 6的表达与年龄、性别、WBC、Hb、BPC、BM中白血病细胞数、CR率及CR期无关 (P值分别为 0 .12 8,0 .877,0 .181,0 .86 6 ,0 .6 2 9,0 .40 7,0 .998,0 .0 96 ) ;与较多的髓外侵润(77.78%对 6 1.11%,P =0 .0 19)、CD34表达 (6 6 .6 7%对 46 .48%,P =0 .0 3)、P170表达 (5 1.79%对 34 .94%,P =0 .0 48)及较短的生存期有关 (中位数 ,11.5个月对 18个月 ;P值 0 .0 478)。结论 :CD5 6 +AML是一种特殊类型的白血病 ,预后较差 ,应进一步分型并针对性治疗。

Purpose:To study the clinical significance and hematologic features of CD56 + Acute Myeloid Leukemia(AML). Methods:The expression of differentiation antigens on the acute myeloid leukemia cells were detected by flow cytometry(FCM);the Epstein-Barr Virus(EBV) mRNA in CD56 + AML leukemic cells by Rt-PCR assay;the ultrastructure of the CD56 + AML leukemia cells were showed by electron microscope and immuno-electron-microscope. The hematologic features and clinical characteristics at the first visit retrospectively analysed as well as the effect of chemotherapy.Results:CD56 expression rate in AML was 30.62%(79/258).EBV-mRNA were negative in all CD56 + AML cells detected.The ultrastructural characteristics showed 1-2 masses floccose objects in nucleus of CD56 + AML leukemic cells,CD56 expression had no correlation with age,sex,WBC,Hb,BPC,Leukemic cell count in BM,CR rate and CR duration(P value is 0.128,0.877,0.181,0.866,0.629,0.407,0.998 and 0.096,respectively),but there was correlation with higher extramedullary involvement(77.78% v 61.11%,P=0.019)?higher expression of CD34 (66.67% v 46.48%,P=0.03),higher expression of P170(51.79% v 34.94%,P=0.048) and shorter survival(Median,11.5 months v 18 months,P=0.0478). Conclusions:AML was a specific subtype of AML,with a poor prognosis.It may be useful to have more detailed classification with appropriate therapy for this subtype.