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目的探讨急性髓细胞白血病(AML)的免疫表型异质性及治疗特点。方法111例初发的成人AML,常规骨髓细胞瑞氏染色及细胞化学染色进行FAB分型,用单克隆抗体标记经流式细胞仪对骨髓细胞进行白血病细胞免疫分型。每个病例用标准方案诱导1个疗程后复查血液学缓解情况。结果111例FAB分型为AML的病例中,免疫学分型为Ly-AML79例(71.2%),Ly+-AML30例(27%),急性混合细胞白血病(acute mixed-lineage leukemia,AMLL)2例(1.8%)。在Ly+-T-AML中,T细胞表面抗原以CD7表达率(89.5%)最高,CD2(22.2%)次之。在Ly+-B-AML中,B细胞表面抗原以CD19表达率(66.7%)最高,CD10(33.3%)次之。用标准诱导缓解方案治疗后,Ly-AML患者CR率63.3%,Ly+-AML患者CR率40%,两者CR率差异有显著性(P=0.028)。结论白血病细胞免疫分型可客观反映细胞来源及分化阶段,经标准诱导缓解后,Ly-AML患者CR率高于Ly+-AML患者。
Objective To investigate the immunophenotypic heterogeneity and therapeutic characteristics of acute myeloid leukemia (AML). Methods 111 cases of primary AML, normal bone marrow cells Wright ’s staining and cytochemical staining FAB typing, labeled with monoclonal antibody by flow cytometry of bone marrow cells leukemia cell immunophenotyping. Hematological responses were reviewed after each course of treatment with a standard regimen. Results Among 111 cases with AML diagnosed by FABA, the immunological genotypes were Ly-AML in 79 cases (71.2%), Ly + -AML in 30 cases (27%) and acute mixed-lineage leukemia (AMLL) in 2 cases 1.8%). In Ly + -T-AML, T cell surface antigen expressed CD7 (89.5%) and CD2 (22.2%). In Ly + -B-AML, B cell surface antigen expressed the highest rate of CD19 (66.7%), followed by CD10 (33.3%). After treatment with standard induction regimen, CR rate was 63.3% in Ly-AML patients and 40% in Ly + -AML patients, the difference was significant (P = 0.028). Conclusions Immunophenotyping of leukemia cells can objectively reflect the cell source and differentiation stage. After standard induction of remission, the CR rate of Ly-AML patients is higher than that of Ly + -AML patients.