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目的探讨高白细胞性急性白血病的临床特征及免疫表型特点。方法采用流式细胞术对48例高白细胞性白血病(HLAL)和189例非高白细胞性白血病(NHLA)患者进行免疫表型检测,并对结果及临床特征进行分析。结果 HLAL与NHLAL比较,患者起病急,进展快,完全缓解(CR)率低(P<0.05),髓外浸润明显,骨髓增生活跃(P<0.05)。高白细胞性急性淋巴细胞白血病(HLALL)可以同时表达不同系列的抗原。HLALL、高白细胞性急性髓系白血病(HLAML)、非高白细胞性急性淋巴细胞白血病(NHLALL)与非高白细胞性急性髓系白血病(NHLAML)4组CD7抗原表达比较差异无统计学意义(P>0.05)。HLAML和NHLAML,髓系抗原表达阳性率较高的均为CD33和CD13。结论 HLAL与NHLAL相比进展较快,骨髓增生更为活跃,预后不良。急性淋巴细胞白血病(ALL)的白血病细胞异质性更高,尤其是HLALL。CD7系列特异性不明显,CD33和CD13作为髓系的特异性抗原较为可靠。
Objective To investigate the clinical features and immunophenotypic features of leukemic acute leukemia. Methods Flow cytometry was used to detect the immunophenotype of 48 cases of HLALT and 189 cases of non-HLBC. The results and clinical features were analyzed. Results Compared with NHLAL, HLAL patients had acute onset, rapid progression, low complete remission (CR) rate (P <0.05), extramedullary infiltration and active bone marrow hyperplasia (P <0.05). HLALL can express different series of antigens simultaneously. The expression of CD7 antigen in HLALL, HLAML, NHLALL and NHLAML group 4 was not significantly different (P> 0.05). HLAML and NHLAML, myeloid antigen expression were positive for the higher rates of CD33 and CD13. Conclusion HLAL progresses faster than NHLAL, myeloproliferation is more active and the prognosis is poor. Acute lymphoblastic leukemia (ALL) leukemia cells are more heterogeneous, especially HLALL. CD7 series specificity is not obvious, CD33 and CD13 as myeloid specific antigen is more reliable.