CD7阳性急性髓系白血病患者细胞遗传学及临床特征分析

Acute myeloid leukemia patients with CD7 positive： analyses of cytogenetic and clinical characteristics

目的探讨CD7阳性急性髓系白血病（AML）患者的细胞遗传学及临床特征。方法2008年1月至2012年12月中国科学技术大学附属第一医院收治的788例AML患者中，CD7阳性140例，分析其临床及细胞遗传学等特征。结果140例CD7阳性AML患者中，法、美、英分型系统（FAB）分型以M5 [47.1 %（66/140）]和M2[27.1 %（38/140）]较为常见；M0、M1患者CD7阳性率较高[（60.9±13.2）%与（53.1±29.5）%]。染色体核型分析结果显示，合并预后不良核型CD7阳性AML患者72例（51.4 %）。31例（22.1 %）的CD7阳性AML患者同时伴其他淋系抗原的表达。CD7阳性AML患者中，伴有白细胞计数增高（≥20×109/L）者占75.0 %（105/140），伴有肝脾大者占82.1 %（115/140）。CD7阳性AML患者中≥65岁者所占比例低于CD7阴性AML患者中≥65岁者[25.7 %（36/140）比39.4 %（255/648），χ2=8.62，P=0.03]；CD7阳性AML患者完全缓解率低于CD7阴性AML患者[12.1 %（17/140）比24.7 %（160/648），χ2=9.70，P=0.01]。结论CD7阳性AML患者具有特定细胞遗传学和临床特征，其预后不良。

ObjectiveTo investigate the cytogenetic and clinical features of acute myeloid leukemia （AML） with CD7 positive.MethodsAmong 788 AML patients in the First Affiliated Hospital of USTC from January 2008 to December 2012, a total of 140 AML patients with CD7 positive were enrolled, and their clinical and cytogenetic characteristics were analyzed respectively.ResultsAccording to French-American-British （FAB） classification systems, M5 [47.1 % （66/140）] and M2 [27.1 % （38/140）] were often detected in 140 AML patients with CD7 positive. The positive rate of CD7 in M0 patients [（60.9±13.2） %] was the highest, followed by （53.1±29.5） % in M1 patient. Karyotype analysis showed that 72 （51.4 %） AML patients with CD7 positive had unfavorable karyotypes. Thirty-one （22.1 %） AML patients with CD7 positive simultaneously showed the expressions of lymphoid antigens. Clinically, some AML patients with CD7 positive was accompanied by hyperleukocytosis [75.0 % （105/140）] （white blood count ≥20×109/L） and hepatosplenomegaly [82.1 % （115/140）]. The proportion of elder patients （above 65 years old） and complete remission rate of AML with CD7 positive were lower than those of AML with CD7 negative [25.7 % （36/140） vs. 39.4 % （255/648）; 12.1 % （17/140） vs. 24.7 % （160/648）, respectively], and there were statistical differences （χ2 = 8.62, P = 0.03; χ2 = 9.70, P = 0.01, respectively）.ConclusionAML patients with CD7 positive have specific cytogenetic and clinical characteristics, and poor prognosis.