急性白血病ABO抗原减弱患者与抗原正常患者的对比研究

Comparison of Weak ABO Antigen and Normal ABO Antigen in Patients with Acute Leukemia

目的:对比急性白血病ABO抗原减弱患者与抗原正常患者的差异,初步探索ABO抗原减弱现象在急性白血病中的临床意义。方法:对110例(AML 68例;ALL 42例)初治急性白血病患者及68例正常对照者进行ABO血型抗原凝集强度的检测,然后对比AL患者ABO抗原减弱组与抗原正常组在一般资料、临床特征、实验室检查、白血病危险度分级及ABO基因启动子甲基化水平等因素之间的差别。结果:110例急性白血病患者中有9例出现ABO抗原减弱,均为AML患者。ALL组和健康对照组ABO血型均无抗原减弱现象。ABO抗原减弱组与抗原表达正常(ALL)组在ABO血型分布、年龄、肝脾淋巴结肿大、血小板计数、骨髓原幼细胞比例、免疫表型、LDH、危险度分级等方面无明显统计学差异(P>0.05)。抗原减弱组男性比例明显高于抗原正常组(77.8%vs 30%),白细胞计数和血红蛋白平含量均明显低于抗原正常组(32.26×10~9/L vs 82.69×10~9/L)(64.00 g/L vs 85.94 g/L),ABO基因启动子甲基化程度明显高于抗原正常组(18.91%vs 10.76%)(P<0.05)。结论:ABO抗原减弱患者以AML男性患者最多见,ABO血型抗原减弱患者ABO基因启动子甲基化水平明显高于抗原正常患者。

Objective： To compare the differences between weak ABO antigen patients and normal ABO antigen patients with acute leukemia,and to explore the clinical significance of weak ABO antigen in acute leukemia. Methods： The ABO blood group was detected in 110 newly diagnosed acute leukemia patients（ including 68 cases of AML and 42 cases of ALL） and 68 normal controls. Then the leukemia subtype,age,sex,laboratory test,risk status of leukemia patients,and DNA methylation of ABO promoter were compared between patients with weak and normal ABO antigen. Results： The weak ABO antigen was found in patients with newly diagnosed acute leukemia,and was not found in ALL patients or normal group. No statistical differences were found in the distribution of ABO blood group,age,hepatosplenomegaly,lymphadenovarix,plt,precursor cell clusters derived from bone marrow,immunopheno-typing,LDH level,and risk status between AL patients of weak and normal ABO antigen groups（P〈0. 05）. Compared with patients in normal ABO antigen group,the pateins in weak ABO antigen group had higher percentage of male（77. 8% vs 30%）,lower WBC（32. 26 × 109/L vs 82. 69 × 109/L） and Hb level（64. 00 g/L vs 85. 94 g/L） and higher DNA methylation level（18. 91% vs 10. 76%）（P〈0. 05）. Conclusion： The cases of weak ABO antigen frequently appear in the male AML patients,the DNA methylation level of ABO gene promoter in patients with weak ABO antigen is significantly higher than that in patients with normal ABO antigen.