111例儿童急性淋巴细胞白血病免疫分型与临床研究  

Immunophenotyping of acute lymphocytic leukemia in 111 children and clinical characteristics

作　　者：蔡耘[1] 陈惠芹[1] 李晓峰[1] 窦娟[1] 王清文[1] 何政贤[1] 

机构地区：[1]中山大学附属第三医院儿科,广东广州510630

出　　处：《中国热带医学》2009年第6期1039-1041,1151,共4页China Tropical Medicine

摘　　要：目的探讨儿童急性淋巴细胞白血病(ALL)免疫表型与临床表现及疗效、预后的关系。方法应用流式细胞仪对111例初治儿童ALL进行免疫分型,比较不同免疫表型ALL的临床表现、强的松反应、首次诱导缓解率、达到完全缓解(CR)的治疗时间和预后情况。结果本组ALL中B细胞型81例(73.0%),T细胞型16例(14.4%),B/T系混合表达14例(12.6%),My+-ALL25例(22.5%),FAB分型与免疫分型无明显相关性;T-ALL患儿淋巴结、肝、脾明显肿大,纵隔肿块发生率及外周血WBC计数高于其它两型(P<0.05),强的松反应敏感率、首次诱导CR率较低,达到CR的治疗时间长;B、T细胞型和B/T混合表达型ALL3年生存率分别为76.9%、75.0%和83.3%,三者无明显差异;My+-ALL与My--ALL的CR率、三年生存率、复发率亦无显著差异。结论单纯免疫分型对白血病疗效及预后所提供的信息有限,应结合细胞遗传学、分子生物学、临床治疗反应等特点进行综合判断。Objective To analyze the immunophenotype of acute lymphocytic leukemia （ALL） in children and its clinical presentation and prognosis. Methods Flow cytometry was used for immunophenotyping of 111 ALL child cases. The clinical characteristics, chemotherapy response and prognosis were compared among different immunophenotype groups. Results Three categories could be identified, including 81 cases （73.0%） of B lineage ALL, 16 cases （14.4%） of T lineage ALL and 14 cases （12.6%） of B/T lineage ALL There were 25 cases （22.5%） of ALL expressing myeloid-associated antigens. There was no relationship between FAB morphology classification and immunophenotype of ALL. T-ALL was significantly associated with markedly lymphadenopathy, splenomegaly, hepatomegaly, mediastinal mass, high white blood cell count and poor response in induction chemotherapy. The 3-year survival rates were 76.9% in B-ALL, 75.0% in T-ALL and 83.3% in B/T-ALL There was no significant difference between the My＋-ALL and My-- -ALL of complete remission rates, 3-year survival rates or relapse rates. Conclusion The immunophenotyping for estimation of the therapeutic effect and prognosis of ALL patients be combined with cytogenetics, molecular biology and clinical manifestations.

关 键 词：急性淋巴细胞白血病 预后 免疫表型 儿童 

分 类 号：R733.71[医药卫生—肿瘤] R730.4[医药卫生—临床医学]