【摘要】 目的:分析成人急性双表型白血病(BAL)的临床和生物学特征。方法:采用流式细胞术检测22例成人BAL患者治疗前骨髓细胞的免疫表型,染色体R显带技术对其中的16例进行核型分析。结果:在同期急性白血病496例患者中BAL发生率为4.4%(22/496),16例(72.7%)为髓系和B系抗原共表达,5例(22.7%)为T系和髓系抗原共表达,T系、B系和髓系均表达者1例(4.5%)。BAL患者CD34阳性率为86.4%,高于同期ALL(60.3%)和AML(62.9%)(P<0.05)。BAL患者中位年龄大于ALL患者(P<0.05)。BAL组肝、脾、淋巴结肿大例数明显高于AML组(P<0.01)。BAL组异常核型占56.3%,Ph染色体阳性率(25%)明显高于AML组(0%)(P<0.01)。结论:成人BAL发病率低,以髓系和B淋巴系抗原共表达为主。BAL患者发病中位年龄高,高表达CD34,Ph染色体阳性者多见,肝、脾、淋巴结浸润发生率高。更多还原

【Abstract】 Objective: To analyze the clinical and biological characteristics of adult biphenotypic acute leukemia( BAL). Methods: Twenty two adult patients with BAL were immunophenotyped by flow cytometry,and 16 cases were also subjected to karyotype analysis by R- banding technology. Results : Of 4 9 6 acute leukemia patients,2 2 cases( 4. 4%) were diagnosed as BAL. Among them,16( 72. 7%) were B lymphoid and myeloid,5( 22. 7%) were T lymphoid and myeloid,1( 4. 5%) was T,B lymphoid and myeloid trilineage differentiation. CD34 was expressed in 86. 4% of BAL cases,which was higher than that in ALL( 60. 3%) or AML( 62. 9%)( P < 0. 05). The median age in BAL group was significantly higher than that in ALL group( P < 0. 05). The incidences of enlargement of liver, spleen and lymphonodes in BAL were higher than those in AML( P < 0. 01). Cytogenetic analysis revealed abnormal karyotypes in 56. 3% of BAL cases and 25% of BAL patients had Philadelphia( Ph) chromosomes,which was significantly higher than that in AML group( 0%)( P < 0. 01). Conclusion : The incidence of adult BAL was lower and the co- expression of B lymphoid / myeloid antigens is the major feature of BAL. BAL patients showed a much higher incidence of older age,CD34 antigen expression,presence of Ph chromosome,and liver,spleen and lymphonodes infiltration.更多还原