【摘要】 本文联合用细胞形态学、细胞化学、免疫学分型、免疫球蛋白重链（IgH）和T细胞受体（TCR）基因重排及电镜下过氧化物酶（EMPO）等多参数研究分析了14例急性未分化型白血病（AUL）。结果发现,AUL均缺乏典型的细胞形态和细胞化学特征,8例表达CD₉、HLA-DR抗原及CD19抗原或可检出IgH基因重排,属早期B细胞来源;4例形态学、细胞化学似ALL,无淋巴系抗原但表达1至多种粒系抗原或对EMPO阳性,属早期粒细胞来源,诊断为MPO^-AML或AML-MO。2例无任何抗原表达属于干细胞或细胞来源不明者。本文还分析了AUL的疗效并发现AUL表达CD19⁺、CD9⁺、DR⁺者对ALL方案效果好。表达粒系抗原者对AML方案反应好,应推荐按其细胞标志选用化疗方案。AUL,CR期短,容易复发,应建议对AUL采用较强诱导化疗及骨髓移植以延长其生存期。最后,本文还讨论了AUL的诊断条件,并建议在Raghavachar诊断标准的基础上增加对CD19^-、CD22^-、CD13^-、CD33^-两点以严格AUL的标准。更多还原

【Abstract】 Morphological, immunological, immunoglobulin heavy chain(IgH)and T cell receptor (TCR) gene rearrangement and myeloperoxidase with electron microscopy (EMPO) features of the 14 patients with acute undifferentiated leukemia (AUL) were studied. Leukemia cells from these patients had no typically morphological feature and negative for MPO, SB and failed to express B cell, and T cell associated antigens. In the eight of 14 patients, leukemia cells expressed CD 19, CD9 and HLA-DR antigens or had IgH gene rearrangement, and most of them had good response for ALL chemotherapy and were considered as early B cell origin. In the four of 14 patients,blasts expressed myeloid antigens or had positive for EMPO, and all of them were defined as AML with peroxidase-negative(MPO-AML) or minimally differentiated AML(AML-Mo) and had good response for AML chemotherapy. Other two cases were not detected any cell markers. The ten of 12 patients who received chemotherapy got complete remission(83.3%) and most of them relapsed in 2 months. These results showed that the leukemia cells in AUL patients were derived from different early stage cells and should be recommended to choose chemotherapy protocol according to their different cell markers. Finally, this paper also discussed the diagnosis of AUL and suggested a much strick diagnosis criterion of AUL.更多还原