T、B免疫双标记型急性淋巴细胞白血病的临床特点

The clinical characteristics of T and B bilineal-immunophenotypic acute lymphoblastic leukemia

目的 :了解T、B免疫双标记型急性淋巴细胞白血病 (ALL)的临床特点 ,以判断预后与指导治疗。方法 :对 4 89例形态学上诊断为ALL的病例 ,取其外周血或骨髓 ,分离出单个核细胞 ,应用APAAP法进一步作免疫表型分析 ,对其中同时表达T、B淋巴细胞表面抗原的免疫双标记型病例的临床特点、化疗疗效及预后进行观察。结果 :4 7例患者同时表达T、B淋巴细胞表面特异性抗原。在临床方面 ,与T淋巴细胞系ALL相比 ,肝、脾、淋巴结肿大或纵隔肿块发生率、白细胞数量均较低 (P <0 .0 5 ) ,但化疗完全缓解率及存活期差异无显著性意义(P >0 .0 5 ) ;与B淋巴细胞系ALL相比 ,肝、脾、淋巴结肿大及纵隔肿块发生率均较高 (P <0 .0 5 ) ,而白细胞数量差异无显著性意义 (P >0 .0 5 ) ,但化疗完全缓解率高、存活期较长 (P <0 .0 5 )。结论

Objective:To observe the clinical characteristics of the patients with acute lymphoblastic leukemia (ALL) which simultaneously expressed the surface markers of both T and B lymphocytic cells(T and B bilineal immunophenotypic ALL).Method:Blood or bone marrow samples were taken from 489 patients who had been diagnosed as ALL by morphology,and APAAP staining method was used for their mononucleur cells (MNCs) immunophenotypic analysis.The clinical characteristics,chemotherapy results and the prognosis of the patients with T and B bilineal immunophenotypic ALL were also studied.Result:There were 47 cases that expressed T and B systemic immunophenotype simultaneously(bilineal immunophenotypic ALL). As contrasting to T ALL cases in clinical features,they would have less opportunities of hepatomegaly, splenomegaly ,lymphnode enlargement,vertical diaphragm mass and hyper leukocytes respectively(P< 0.05 ) ,but there would have no significantly difference in chemotherapy complete remission and survival times between them(P> 0.05 ).While contrasting to B ALL,they would have more opportunities of hepatomegaly,splenomegaly,lymphnode enlargement and vertical diaphragm mass respectively(P< 0.05 ),but not of hyper leukoytes(P> 0.05 ),however, they would have even higher complete remission and longer survival time.Conclusion:The T and B bilineal immunophenotypic ALL cases might have better prognosis.