急性红白血病生物学特征及临床疗效探究.docVIP

急性红白血病生物学特征及临床疗效探究 　【摘要】 　　本研究探讨急性红白血病（AMLM6）的生物学特征与临床疗效的关系。 对29例M6初治患者细胞形态学、免疫表型和染色体核型进行回顾性分析并观察临床化疗效果，同时随机抽取30例AMLM2（急性粒细胞白血病部分分化型）作为对照。结果表明： M6患者的外周血中均可见幼稚细胞（2％-10％）及有核红细胞，骨髓穿刺细胞学检查显示19例伴有多系细胞发育异常，累及二系细胞或三系细胞。流式细胞术检测表明，M6 GlyA（血型糖蛋白A）的表达率高达（66.67±23.86）％，明显高于其在M1，M2，M3，M4和M5中的阳性表达率(Plt;0.01)。M6高表达HLADR［（60.00±24.79）%］,CD34［（40.00±24.79）%］，CD38［（33.33±23.86）%］，髓系抗原主要表达CD13［（66.67±23.86）%］，MPO［（33.33±23.86）%］，CD33［（46.67±25.25）%］,CD15［（33.33±23.86）%］,CD117［（46.67±25.25）%］。部分病例伴有淋系抗原的表达,如CD3、CD4、CD19，其中CD4的表达高达26.67％。M6中CD38、CD33、CD15、MPO的阳性表达率低于M2患者。9例M6患者染色体的检查显示，4例存在核型异常，异常率达44.44％，其中复杂核型异常1例。M6患者化疗完全缓解率为29.41％，低于M2患者化疗完全缓解率（68.18％， Plt;0.01)。结论： GlyA是鉴别M6与其他亚型急性髓性白血病的一个重要标志，M6有自己独特的生物学表型，其化疗效果不佳可能与其生物学特征有关。 【关键词】 急性红白血病 AMLM6 免疫表型 核型 　　Biological Characteristics and Therapeutic Effect of Acute ErythoLeukemia Abstract The objective of this study was to investigate the biological characteristics and the therapeutic effect in patients with acute erythroleukemia (AMLM6). Morphology, immunophenotype and cytogenetics were retrospectively analyzed in 29 patients with AMLM6 and were compared with 30 AMLM2 patients. The results showed that there were immature cells (2%-10%) and erythroblast, and puncture of bone marrow revealed myelodysplastic features involving multiple hemopoietic lineages in bone marrow of 19 patients. Flow cytometry indicated that the expression frequency of GlyA in M6 significantly increased (66.67±23.86)% and higher than that in M1, M2, M3, M4 and M5 (Plt;0.01). The expression frequencies of HLADR (60.00±24.79％), CD34 (40.00±24.79％), CD38 (33.33±23.86％) in M6 were high, and the frequencies of myeloid immunophenotypes CD13 (66.67±23.86％), MPO (33.33±23.86％), CD33 (46.67±25.25％), CD15 (33.33±23.86％), CD117 (46.67±25.25％) were common as well in M6. Lymphocytic immunophenotypes CD3, CD4, CD19 were detected in part of patients with M6, and the expression frequencies of CD4 was 26.67%. The expression frequences of CD38, CD33, CD15, MPO in M