CD20阳性表达及与儿童急性B淋巴细胞白血病预后相关性研究

Study on positive expression of CD20 in childhood B-lineage acute lymphoblastic leukemia and relationship with prognosis

目的探讨急性B淋巴细胞白血病患儿CD20阳性表达情况及与预后关系。方法选取初诊急性B淋巴细胞白血病患儿136例,所有患儿均进行免疫分型、骨髓细胞形态、细胞遗传学检测和微小残留病变(MRD)筛选,对有MRD标记的患儿在诱导化疗缓解的第35d再次对MRD进行监测。根据CD20表达情况进行分组,对不同组患儿临床特征及生存情况分析。结果 136例初诊急性B淋巴细胞白血病患儿CD20阳性表达率39.7%;CD20阳性表达与性别、年龄、血常规形态学分型、危险度分型、细胞遗传学均无统计学相关性;CD20阳性组患儿在诱导化疗缓解第35d MRD≥0.01的比例为37.0%,高于CD20阴性组的17.0%,差异具有统计学意义(P<0.05);生存分析显示,CD20阳性组患儿总体生存时率为75.9%,低于CD20阴性组的82.9%,无事件生存时间为(66.930±4.326)%,低于CD20阴性组的(73.343±4.477)%,但差异均无统计学意义(P>0.05)。结论推测CD20阳性表达可能是影响急性B淋巴细胞白血病患儿预后的危险因素,为下一步研究确证提供了线索。

Objective To investigate the positive expression of CD20 in childhood B - lineage acute lymphoblastic leuke- mia and the relationship with prognosis. Methods Totally 136 cases of children diagnosed as B - lineage acute lympho- blastie leukemia in Zhengzhou Children＇ s Hospital were selected from January 2009 to July 2013. Immunophenotyping, bone marrow cell morphology, minimal residual disease and cytogenetics were detected. For MRD labeled children, MRD were monitored again in remission induction 35d. All cases were divided to different groups by the expression of CD20, the clinical characteristics and survival situations were analyzed in different groups. Results The CD20 positive expression rate among 136 cases of newly diagnosed childhood B - lineage acute lyrnphoblastic leukemia was 39. 7%. There were no statistical correlation between CD20 expression and gender, age, WBC, HB, PLT, morphologic classifi- cation, risk classification and the cytogenetic. The proportion of MRD≥0. 01 in remission induction chemotherapy 35d in CD20 positive group was 37.0% , which was higher than 17.0 of CD20 negative group, the difference was statistically significant （P 〈0.05）. Smwival analysis showed, the OS of CD20 positive group was 75.9% , which was lower than 82. 9% of CD20 negative group, EFS was （66. 930 ± 4. 326 ） %, which was lower than （73. 343± 4. 477 ） % of CD20 negative group, but there were no statistical difference significances （P 〉 0. 05）. Conclusion It speculated that CD20 positive expression may be a risk factor for effect the prognosis of childhood B - lineage acute lymphoblastic leukemia. It provided a clue for further confirmed research.