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目的探讨急性双表型白血病(BAL)的诊断标准。方法对400例急性白血病(AL)初诊患者骨髓标本进行免疫分型,分别用Catovsky(1991年)和EGIL(1998年)新标准对其评分,筛选出BAL及伴淋/髓系表达的AL并将其分为4组进行分析:Ⅰ组积分≥2分;Ⅱ组积分>2分;Ⅲ组积分=2分;Ⅳ组积分0.5～1.5分。结果Ⅰ组和Ⅱ组白细胞中位数、肝脾淋巴结肿大例数均明显高于Ⅳ组,差异有统计学意义(P<0.05),Ⅲ组白细胞中位数、肝脾淋巴结肿大例数与Ⅰ组和Ⅱ组相比差异无统计学意义(P>0.05),与Ⅳ组相比差异有统计学意义(P<0.05);CR率分别为34.4%,37.5%,38.5%,65.0%。Ⅰ组、Ⅱ组CR率与Ⅳ组相比差异有统计学意义(P<0.05),Ⅲ组CR率与Ⅰ组,Ⅱ组相比差异无统计学意义(P>0.05),与Ⅳ组相比差异有统计学意义(P<0.05)。结论EGIL(1998年)标准评分较Catovsky(1991年)标准科学,但过于严格,该组结果表明,积分为2分病例在生物学特性上与BAL相符,而不同于伴淋/髓系表达AL,EGIL(1998年)标准以≥2分为界可能更为合理。
Objective To investigate the diagnostic criteria of acute dual leukemia (BAL). Methods 400 cases of acute myeloid leukemia (AL) newly diagnosed patients with bone marrow specimens were immunophenotype, respectively, with Catovsky (1991) and EGIL (1998) the new standard score, screened BAL and lymphocytes with myeloid / Divided into four groups for analysis: Ⅰ points ≥ 2 points; Ⅱ points> 2 points; Ⅲ points = 2 points; Ⅳ points 0.5-1.5 points. Results The median number of leukocytes and the number of hepatosplenomegaly in group Ⅰ and group Ⅱ were significantly higher than those in group Ⅳ (P <0.05). The median number of leukocytes in group Ⅲ and the number of enlarged lymph nodes in liver and spleen (P <0.05). The CR rates were 34.4%, 37.5%, 38.5% and 65.0% respectively, which were significantly different from those in group Ⅰ and group Ⅱ (P> 0.05) . The CR rates of group Ⅰ and group Ⅱ were significantly different from those of group Ⅳ (P <0.05). The CR rate of group Ⅲ was not significantly different from that of group Ⅰ and group Ⅱ (P> 0.05) The difference was statistically significant (P <0.05). CONCLUSION: The EGIL (1998) standard score is more scientific than that of Catovsky (1991) standard science. However, the results of this study showed that the score of 2 points corresponded to the biological characteristics of BAL and was different from those of patients with lymphoid / myeloid expression of AL , The EGIL (1998) standard may be more reasonable by dividing it by more than or equal to 2.