伴骨髓增生异常相关改变的急性髓细胞白血病的免疫表型及临床特征

摘要

目的 分析伴骨髓增生异常相关改变的急性髓细胞白血病( AML-MRC)的白血病相关免疫表型(LAIP)及临床特征.方法 对117例初治AML患者进行重新WHO分型诊断,分析其中37例AML-MRC患者发病时经流式细胞术(FCM)检测的免疫表型结果,以45例非特殊类型AML (AML-NOS)患者为对照组.并对两组患者的发病年龄、骨髓原始细胞比例、WBC、Hb、PLT、染色体核型以及诱导化疗疗效进行比较.结果 AML-MRC组与AML-NOS组比较,其白血病相关免疫表型阳性检出率高.AML-MRC组患者骨髓原始细胞比例(40.6％ vs.54.8％,P＜0.01)及WBC计数(19.2×109/L vs.49.2×109/L,P＜0.01)较AML-NOS组患者低,不良预后核型比例高(28.0％ vs.0％,P＜0.01),CR率明显减低(22.7％ vs.69.7％,P＜0.01).结论 AML-MRC做为WHO新定义的一种类型,具有易于表达白血病相关免疫表型、不良预后核型比例高、常规化疗疗效不佳等特点.%Objective To analyze the leukemia associated immunophenotype ( LAIP) and clinical characteriza tion of acute myeloid leukemia with myelodysplasia-related changes (AML-MRC). Methods 117 patients with de novo AML were re-classified. The immunophenotype results of 37 cases of AML-MRC patients detected by FCM were analyzed and 45 cases of non specified AML( AML-NOS) were used as controls. The age, proportion of bone marrow blast cells, WBC, Hb, PLT, karyotype and induction chemotherapy curative effect between two groups were analyzed. Results The positive rate of the leukemia associated immunophenotype in AML-MRC group was higher compared with AML-NOS group. Patients with AML-MRC showed a lower proportion of bone marrow blast cells (40. 6% vs. 54. 8% , P < 0. 01 ) and WBC count (19. 2 x 109/L vs. 49. 2 x 109/L , P < 0. 01) , higher poor prognosis karyotype (28. 0% vs. 0% ,P <0.01) and lower CR rate (22. 7% vs. 69. 7% , P <0. 01 )than that patients with AML-NOS. Conclusion The the AML-MRC is easy to express leukemia associated immunophenotype with characteristics of high poor prognosis karyotype ratio and poor response of conventional chemotherapy.