CD20阳性成人急性B淋巴细胞白血病患者临床特点及预后相关分析  

Clinical features and survival analysis of patients with CD20 positive adult B-lineage acute lymphoblastic leukemia

作　　者：徐皓[1] 魏旭东[1] 尹青松[1] 汪萍[1] 米瑞华[1] 艾昊[1] 汪晓姣 李玉富[1] 朱兴虎[1] 张龑丽[1] 宋永平[1] 

机构地区：[1]郑州大学附属肿瘤医院、河南省肿瘤医院血液科,450008

出　　处：《中华血液学杂志》2015年第1期4-9,共6页Chinese Journal of Hematology

基　　金：国家自然科学基金（81170520）

摘　　要：目的 分析CD20在成人急性B淋巴细胞白血病（B-ALL）患者中的表达及CD20阳性B-ALL患者的临床特点和预后.方法 回顾性分析郑州大学附属肿瘤医院血液科2007年5月至2011年7月收治的168例初治成人B-ALL患者,其中CD20阳性58例,阴性110例.对比分析两组患者的临床特点和生存情况.结果 CD20阳性与阴性组在性别、年龄分布及贫血、血小板减少、肝脾或淋巴结肿大、髓外浸润、Ph染色体阳性、髓系抗原表达、早期死亡、高危患者比例方面差异均无统计学意义（P值均＞ 0.05）,CD20阳性组患者初诊时中位白细胞计数（19.2×10^9/L）和高白细胞计数患者比例（37.9％）明显高于CD20阴性组（6.93×10^9/L和20.9％）,差异有统计学意义（P值均＜0.05）;两组诱导缓解治疗4周完全缓解率分别为78.6％和76.9％,差异无统计学意义（P＞0.05）,3年累积复发率分别为59.3％和42.5％,差异有统计学意义（P＜0.05）.多因素分析显示CD20 阳性是影响患者总生存（P=0.004）和疾病无进展生存（P=0.001）的独立预后不良因素 结论 CD20阳性表达与成人B-ALL患者外周血白细胞计数相关,且CD20阳性者预后不良.Objective To explore the clinical and survival significance of CD20 positive adult patients with B-lineage acute lymphoblastic leukemia （B-ALL）.Methods The clinical features and survival of 168 adult patients with B-ALL diagnosed and treated in our department from May 2007 to July 201 1 were analyzed retrospectively,58 expressed CD20 and 110 not.Results The sex,distribution of age,anemia,thrombocytopenia,infiltration of liver,spleen and lymph nodes,the expression of myeloid lineage marker,incidence of Ph chromosome,complete remission within 4 weeks showed no significant differences in CD20 positive and negative groups （P 〉 0.05）; median white blood cell count at diagnosis and the rate of patients with high white blood cell count in CD20 positive group were 19.2 ×10^9/L and 37.9% respectively,which were significantly higher than those of 6.93 ×10^9/L and 20.9% in CD20 negative group （P 〈 0.05）; cumulative incidence of relapse between two groups showed significant difference （P 〈 0.05）; multivariable analysis for overall survival and progress-free survival identified CD20 positivity as independent predictor.Conclusion The expression of CD20 in adult patients with B-ALL appeared to be associated with high white blood cell count and poor prognosis.

关 键 词：抗原 CD20 白血病 B细胞 急性 疾病特征 存活率分析 

分 类 号：R733.71[医药卫生—肿瘤]