The Clinical Analysis Of 22 Cases In Patients With Philadelphia Chromosome-positive Acute Lymphocytic Leukemia

Objective: to approach the clinical feature, cytogenetics, molecular biology, immunophenotype, and the curative effect of Philadelphia chromosome (Ph)-positive acute lymphocytic leukemia (ALL), and to study them with Ph-ALL homeochronous.Mehods: we studied 22 cases of patients who诊断diagonosed Ph-positive ALL in JiLin university No.1 hospital from 2002 to 2008, we summaried the clinical datas, including the general state of health, clinical symptoms, laboratory examinations, therapeutic measure and the evaluation of curative effect.Results:①there were 34 Ph positive ALL patients total (14.0%), we chose 22 patients in this study for they have whole data, in the group, the proportion of patients exceeded 50 years old is abbiously high than Ph-ALL group.②there were 6 patients with central nervous system leukemia (CNS-L) in Ph+ALL group (27.3%), which is more than the control group (8.3%, 13/156) (P<0.01).③complete to the white blood cell counts, in Ph+ALL group WBC>50×109/L showed 45.5%, while the Ph- ALL25%, they have stastics difference (p<0.05).④In the Ph+ group, there were more patients had additional chromosome abnormalities (45.5%) than Ph-ALL group (10.3%) (p<0.01), the abnormal karyotype including chromosome 7, chromosome 15 and chromosome 8, there were Ph chromosome with bcr/abl mRNA positive in all the 22 cases, no cases with Ph positive but bcr/abl negative.besides the 22 cases, there were still 6 cases which had no Ph chromosome but with bcr/abl positibe.⑤I n both the two groups, B-cell antigen expression was found with Ph+ALL 45.5% patients had medullary system antigen expression.which contrast to 9% in Ph- ALL group.⑥In the 22 cases, there were 10 reached complete remission (CR), remission rate 45.5%. is obviously lower than Ph-ALL group 69.9% (p<0.05).Conclusions:①Ph+ALL is a group of patients with unfavourable prognosis. the age of onset is usual old, and there are no typical clinical features. The incidence rate of central nervous system leukemia is high;②ontrast to Ph-ALL, there are more white blood cell count in peripheral blood. Have more additional chromosome, with more B precursor cell and medullary system antigen expression, all these may lead to the prognosis mala;③the remission rate of the Ph+ALL is lower than Ph-ALL.