小儿急性白血病和恶性淋巴瘤免疫表型分析及临床意义

THE RELATIONSHIP OF IMMUNOPHENOTYPE AND CLINICAL SIGNIFICANCE IN ACUTE LEUKEMIA AND MALIGNANT LYMPHOMA

①目的 探讨小儿急性白血病 (AL)和恶性淋巴瘤 (ML)免疫表型与其预后的关系。②方法 将标本(骨髓液、外周血或实体瘤组织 )分离出单个核细胞 ,用单克隆抗体 (McAb)处理 ,采用间接免疫荧光法进行分型 ;统计学处理采用 χ2 检验。③结果 2 4 1例AL中B细胞性白血病 (B ALL) 1 4 7例 ,T细胞性白血病 (T ALL) 1 4例 ,混合性急性白血病 (HAL) 1 1例 ,急性髓细胞白血病 (AML) 6 9例。 1 1例ML中非霍奇金病 (NHL) 9例 ,其中BⅢ型 3例 ,BⅣ型 1例 ,BⅥ型 1例 ,TⅡ型 2例 ,TⅢ型 1例及非T非B型 1例 ;2例霍奇金病均为A+ B+ 型 (BⅣ /TⅡ及BⅤ /TⅡ )。HLA DR阳性是影响AML化疗的不利因素 ,CD3 4 阳性在ALL中标志着预后良好 ,但在儿童髓细胞白血病中是预后不良的标志 ;恶性淋巴瘤的免疫表型和病理类型的恶性程度一致。

Objective\ To study the relationship of immune phenotype and prognosis in children with acute leukemia (AL) and malignant lymphoma (ML).\ Methods\ An individual nuclear cell was separated from marrow liquid, peripheral blood and tumor tissue and treated with monoclone antibody (McAb). A typing was done by indirect immunofluorescence. The data was analyzed by χ 2 test. \ Results\ In 241 cases of AL, there were 147 cases of acute B cell leukemia (B ALL), 14 acute T cell leukemia (T ALL), 11 acute hybrid leukemia (HAL) and 69 myeloid leukemia (AML). There were 9 cases with non Hodgkins lymphoma (NHL) in 11 ML, in which, types BⅢ(3 cases),BⅣ(1), BⅥ(1), TⅡ(2), TⅢ(1) and non T or B(1) were found. The 2 cases with HD were the A + B + type (BⅣ/TⅡ and BⅤ/TⅡ). The positive expression of HLA DR was disadvantageous factor of chemotherapy for AML. The positive CD 34 indicated favorable prognosis for ALL, but it indicated poor prognosis for AML in children. The immune phenotype of ML was consistent with malignant degree pathologically.\ Conclusion\ There is a close relationship between immune phenotype of AL and ML and prognosis.