双表型急性白血病临床研究  

Study on the clinical characteristics of biphenotypic acute leukemia

作　　者：秘营昌[1] 卞寿庚[1] 孟庆祥 薛艳萍[1] 于明华[1] 陈桂彬[1] 李大鹏[1] 陈玉梅[1] 钱林生[1] 

机构地区：[1]中国医学科学院,中国协和医科大学血液学研究所,血液病医院,天津300020 [2]深圳市中心医院

出　　处：《中华血液学杂志》2000年第7期352-354,共3页Chinese Journal of Hematology

摘　　要：目的　分析双表型急性白血病的生物学特点、临床疗效及预后。方法　采用间接免疫荧光法分析急性白血病的免疫表型 ,根据EGIL标准诊断双表型急性白血病。结果　①双表型急性白血病的构成比为 3.4% ,其中B系、髓系抗原共同表达的占 6 8.4% ,T系、髓系共同表达的占 2 1.1% ,T系、B系、髓系均表达的占 10 .5 %。②其CD34 阳性率为 43.8%。③正常核型占 41.7% ,异常核型占5 8 3% (核型异常涉及 9,2 1,8,2 2 ,11,12等染色体 )。④ 19例患者治疗完全缓解 6例 (31.6 % ) ,部分缓解 1例 ,总有效率为 36 .8% ;无病生存期 (DFS)均 <6个月。疗效与CD34 表达呈负相关 ,与染色体核型有关。结论　双表型急性白血病以B系和髓系共同表达最常见 ,治疗效果差 ,生存期短。Objective To analyze the biological characteristics and the treatment outcome of adult biphenotypic acute leukemia. Methods Immunophenotypes were examined using indirect immunofluoresence method. Biphenotypic acute leukemia (BAL) was diagnosed according to EGIL scoring system. Results ① The incidence of BAL in acute leukemia was 3.4%. Percentage for coexpression of B lymphoid and myeloid antigens was 68.4%, for T lymphoid and myeloid antigens 21.1%, for B、T lymphoid and myeloid antigens 10.5%. ②CD 34 was expressed in 43.75% of the BAL cases. ③Cytogenetic analysis revealed normal and abnormal karyotypes in 41.7% and 58.3% of the BAL cases, respectively. ④Six of 19 patients achieved completed remission (CR), but the disease free survivals were all less than 6 months. Treatment outcomes were negatively related to the expression of CD 34 antigen and cytogenetic findings. The BAL patients were poorly responded to therapeutic regimens directed to AML. Conclusion Coexpression of B/M antigens is the commonest subtype in BAL. BAL had a poor prognosis, especially treated with induction regimen directed to AML.

关 键 词：双表型急性白血病 免疫表型 染色体 治疗 诊断 

分 类 号：R733.7[医药卫生—肿瘤]