40例慢性淋巴细胞白血病临床回顾分析  

Clinical retrospective analysis of 40 patients with chronic lymphocytic leukemia

作　　者：李凌浩[1] 王智[1] 陆时运[1] 赵晓红[1] 周仲昊[1] 王晨[1] 曹海武[1] 

机构地区：[1]南京医科大学附属无锡第二医院血液科,江苏无锡214002

出　　处：《齐齐哈尔医学院学报》2015年第28期4218-4221,共4页Journal of Qiqihar Medical University

基　　金：南京医科大学科技发展基金重点项目(2014NJMUZD038);无锡市医院管理中心医学科技发展基金项目(YGM1117)

摘　　要：目的认识慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)临床特征。方法对40例CLL患者临床资料进行回顾性分析。结果 60岁以上者占90%,男女比例为2.1∶1,发现一家族中2人患病;免疫表型均为B淋系,其中CD19阳性、CD23阳性、FMC-7阴性比例均为100%,CD5和CD20的阳性比例均为92%;均未检测到常见白血病融合基因;染色体异常比例高达47%,包括del(13q14)、del(13q14),delRb1、47,XX,+12、46,XX,der(10),der(17)dic(9;17)、46,XX,t(5;13)(q33;q34)、45,XY,3q+,-6;以氟达拉滨为基础的方案显著提高疗效;疗效与年龄、性别、分期、阿司匹林以及他汀类药物无关。结论 CLL多发于老年男性,具有家族聚集性发病特点,免疫表型具有一定特征,是其诊断的重要依据,染色体异常发生比例高且多见复杂核型,以氟达拉滨为基础的方案能够有效提高其治疗效果。Objective To analyze the clinical characteristics of patients with chronic lymphocytic leukemia（ CLL）. Methods The clinical data of 40 CLL patients were analyzed retrospectively. Results Patients with more than 60 years of age accounted for 90% and the male to female ratio is 2. 1： 1. Two patients were identified in one family. Immunophenotyping of all patients were B lymphatic expression. All of them expressed CD19,CD23,but none of them expressed FMC-7. The positive proportion of both CD5 and CD20 was92%. None of the 29 kinds of leukemia fusion genes were detected in these patients. Six kinds of chromosome abnormality including del（ 13q14）,del（ 13q14）,delRb1,47,XX, ＋ 12,46,XX,der（ 10）,der（ 17） dic（ 9; 17）,46,XX,t（ 5; 13）（ q33; q34） and 45,XY,3q ＋,- 6 were founded and the proportion is 47%.Fludarabine-based chemotherapy results in a major benefit for CLL patients. The curative effect was not significantly associated with age,sex,stage,aspirin and statin drugs. Conclusions CLL mostly attacks the elderly male patients, and exhibits familial aggregation. The immune phenotype of CLL shows certain characteristics,which is an important basis for the diagnosis. Chromosomal abnormalities occur in CLL with high proportion and often are complex. Regimens based on Fludarabine effectively improve the therapeutic effect of CLL.

关 键 词：慢性淋巴细胞白血病 回顾性分析 免疫表型 氟达拉滨 

分 类 号：R733.72[医药卫生—肿瘤]