交叉表达淋系和髓系抗原的急性白血病免疫表型及预后分析  

Immunophenotype Characteristics and Prognosis of Acute Leukemia Patients with Cross Expressing Lymphoid and Myeloid Lineage Associated Antigens

作　　者：蒋能刚[1] 陈小梅[1] 朱焕玲[2] 钟凌[1] 曾婷婷[1] 贾永前[2] 

机构地区：[1]四川大学华西医院实验医学科,四川成都610041 [2]四川大学华西医院血液科,四川成都610041

出　　处：《中国实验血液学杂志》2010年第6期1405-1409,共5页Journal of Experimental Hematology

摘　　要：本研究探讨交叉表达淋系和髓系抗原的急性白血病患者的免疫表型及其与预后的关系。用流式细胞术检测白血病细胞的免疫表型,根据免疫标记和FAB亚型将交叉表达髓系和淋系相关抗原的急性白血病进行分组,对于急性髓系白血病(AML)所分析的淋系抗原标志物包括CD2、CD7、CD19、CD56以及其他多个同时表达的淋系抗原,对于急性淋巴细胞白血病(ALL)所分析的髓系抗原标志物包括CD13及同时表达的CD13/CD33。以同期无交叉抗原表达的AML和ALL作为对照,比较各组白血病的完全缓解(CR)率和无复发生存期(RFS)有无差别。结果表明:161例确诊并接受治疗的患者中,91例交叉表达淋系和髓系抗原的急性白血病分为仅伴CD7表达的AML即CD7(+)AML24例,仅伴CD19表达的AML即CD19(+)AML14例,伴CD2表达的AML即CD2(+)AML(包括CD2与CD19共表达病例)8例,伴CD56表达的AML即CD56(+)AML(包括CD56与CD2或CD19共表达病例)10例,表达2个及2个以上淋系相关抗原的AML即Ly≥2(+)AML16例,仅伴CD13表达的ALL即CD13(+)ALL9例,伴CD13、CD33同时表达的ALL即CD13/CD33(+)ALL10例。无淋系抗原表达的AML即Ly(-)AML和无髓系抗原表达的ALL即My(-)ALL分别为41例、29例。与Ly(-)AML相比,Ly≥2(+)AMLCR率、RFS均明显偏低;CD56(+)AML的RFS较低,但CR率无明显差别;其余各组与Ly(-)AML相比CR率、RFS均无明显差别。CD13(+)ALL组、CD13/CD33(+)ALL组与My(-)ALL组相比CR率、RFS亦无明显差别。结论:急性白血病中各抗原标志物的交叉表达对预后的意义应区别对待。AML伴CD56表达或多个抗原交叉表达时预后较差,而其他交叉表达的髓系或淋系抗原标志物对预后无明显影响。The aim of study was to investigate the immunophenotype characteristics and prognosis of actue leukemia patients with cross-expressing lymphoid and myeloid lineage-associated antigens. The immunophenotypes of leukemic cells were examined by using flow cytometry. All patients were classified into several groups according to FAB subtypes and immunophenotyping.The cross-expressed antigens analyzed for AML included CD2, CD7, CD19, CD56 and other co-expressed lymphoid antigens. The myeloid antigens analyzed for ALL included CD13 and co-exprssed CD13/CD33. ALL and AML patients without expression of cross-expressing antigens were selected as control. Complete remission（CR） ratio and relapse-free survival（RFS） of patients in all groups were compared. The results indicated that among 161 patients analyzed, 91 cases of AML with cross-expressing lymphoid and myeloid antigens included that 24 cases of AML expressed lymphoid surface marker-CD7, namely CD7（＋）AML, 14 caeses of AML only expressed lymphoid surface marker-CD19, namely CD19（＋）AML, 8 caeses of AML expressed lymphoid surface marker-CD2 （including CD2/CD19 co-exprssed）, namely CD2（＋）AML, 10 caeses of AML expressed lymphoid surface marker-CD56（ including CD56/CD19 or CD56/CD2 co-exprssed）, namely CD56（＋）AML, 16 cases of AML expressed two or more lymphoid surface markers, namely Ly≥2（＋）AML, 9 cases of ALL expressed myeloid surface markers CD13, namely CD13（＋）ALL, 10 cases of ALL expressed myeloid surface markers CD13 and CD33, namely CD13/CD33（＋）ALL. 29 cases of ALL did not expressed myeloid surface markers, namely My（-）ALL, and 41 caese of AML did not expressed lymphoid surface markers, namely Ly（-）AML. CR ratio and RFS of Ly≥2（＋）AML patients were lower than those of Ly（-）AML patients. RFS of CD56（＋）AML patients was lower, but CR ratio had no significant diffe-rence, when compared with Ly（-）AML patients. CR ratio and RFS of other AML patients with cross-expressing antigens had no

关 键 词：急性白血病 免疫表型 交叉表达 淋系抗原 髓系抗原 

分 类 号：R733.71[医药卫生—肿瘤]