12例急性双系列白血病细胞形态学与免疫表型分析

Cell morphology and immunophenotype in 12 patients of acute bilineage leukemia

目的探讨急性双系列白血病(a BLL)细胞形态学与免疫表型的关系。方法回顾分析12例a BLL患者的骨髓细胞形态、组织化学染色,同时进行免疫表型(HLA-DR、CD34、MPO、CD13、CD33、CD11b、CD117、CD14、CD64、CD3、CD4、CD7、CD10、CD19、CD20、CD22、CD79a)检测。结果 12例a BLL患者FAB分型与免疫表型分型既有一定的差异性,同时也有较好的互补性。12例a BLL患者中,细胞形态学诊断为急性髓细胞白血病(AML)6例,其中4例为M2、2例为M1;2例诊断为急性混合细胞白血病(AMLL);4例诊断为急性淋巴细胞白血病(ALL-L2)。免疫表型诊断为a BLL的12例中髓-B淋巴细胞混合(My-B)10例、髓-T淋巴细胞混合(My-T)2例。结论 a BLL是一种少见类型的白血病,免疫表型与细胞形态学有一定的互补性,能有效降低a BLL的误诊率和漏诊率。

Objective To investigate the relationship between cell morphology and immunophenotype of acute bilineage leukemia（aBLL）.Methods A total of 12 aBLL patients were enrolled, and the marrow cell morphology and histochemistry staining were performed.The immunophenotype was detected, including HLA-DR, CD34, MPO, CD13, CD33, CD11b, CD117, CD14, CD64, CD3, CD4, CD7, CD10, CD19, CD20, CD22 and CD79a.Results There were not only some differences but also complementaries between FAB and immunophenotype classification of aBLL.Of the 12 aBLL patients, 6 cases were diagnosed by cell morphology as acute myeloid leukemia （AML） [M2 （4 cases） and M1 （2 cases）], 2 cases as acute mixed lineage leukemia （AMLL） and 4 cases as ALL-L2, respectively.The 12 cases were diagnosed by immunophenotype classification as aBLL, while 10 cases were myeloid-B lymphocyte mix （My-B）, and 2 cases were myeloid-T lymphocyte mix （My-T）.Conclusions aBLL is a rare type of leukemia.The complementarity between immunophenotype and cell morphology can effectively reduce the misdiagnosis and missed diagnosis of aBLL.