Analysis Of Immunophenotype Feature And Clinical Significance In Acute Myeloid Leukemia

Objective:To explore the immunophenotyp of leukemia cells and its clinical significance inacute leukemia（AL）patients.Methods:There are148cases of acute leukemia patients, including140cases of acutemyeloid leukemia and8cases of acute mixed leukemia. The immunophenotype of allpatients were analyzed with flow cytometry. Acute myeloid leukemia （non-M₃） weretreated with the regimen of DA or IA; M₃were treated with ATRA or ATRA+As2O3（all-trans retinoic acid, arsenic trioxide）which combined with chemotherapy; MALwere treated with the regimen of TOAP or DOLP; and then observation of curativeeffect. Analyzing the difference of CR rate between lymphoid antigen positive AMLand lymphoid antigen negative AML, and the difference of CR rate between myeloidantigen positive AL and myeloid antigen negative AL.Results:1. Six cases in the group of148patients, which cann’t typed by the cellmorphology were diagnosed with immunological detection according to the cellsurface or intracellular antigen expression characteristics, including2cases of M₁,4cases of M₅. It was about93.24%equal with immHnophenotyping-diagnosis andFAB-diagnosis．2. In148patients, there were8cases of mixed leukemia,140patients with AML.In AML patients, M₄incidence was the highest, followed by M₅, M₂, M₃, M₁, M₆andminimum morbidity.In140patients with AML antigen expression from high to low asCD38、CD13, CD33, HLA-DR, CD64, CD34, CD11b, CD56, CD14; lymphoidantigen CD7, CD19,CD4,CD2express in AML, CD20is negative. The expressionlevel of CD34and HLA-DR in M₃was significantly lower than the other subtypes ofAML, CD56more common. 3. The CR rate of AML is56.84%（53/93）, the rate of MAL is33.3%（1/3）.4. The CR rate of CD7⁺-AML was39.28%（11/28）, which was lower than65.63%（42/64） from CD7^--AML（P<0.05）. The CR rate of CD19⁺-AML was91.67%（11/12）, which was higher than52.50%（42/80） from CD19^--AML（P<0.05）.And, the CR rate of Ly⁺AML was46.81%（22/47）,while Ly^-AML was68.89%（31/45）,there was statistical significance amony them（P<0.05）.5. CD34, CD7antigen expression of high consistency, and the CR rate in doublepositive patients is lower than the patients with CD34positive and CD7negative,there is significant difference between the two; while the CR rate in CD34, CD19double positive patients is higer than the patients with CD34positive and CD19negative, and the difference was statistically significant; CD34, CD11b doublepositive patients in remission rate higher than that of CD34⁺, CD11b-patients inremission rate, but the difference was not statistically significant.6. The CR rate of CD34⁺-AML was57.14%（32/56）, which was lower than58.33%（21/36） from CD34^--AML（P>0.05）. The CR rate of HLA-DR⁺-AML was57.58%（38/66）, which was litter lower than57.69%（15/26） fromHLA-DR^--AML（P>0.05）. And, the CR rate of CD38⁺-AML was60%（48/80）,whileCD38^--AML was41.68%（5/12）, there was no statistical significance amonythem（P>0.05）.Conclusion:1.Immunophenotyping of leukemia cells could be helpful for classification ofsome specific type of acute leukemia and has important clinical significant ineva1uating the prognosis of AL.2.The expression of a single antigen for leukemia prognostic significance stillneeds a further study; expression of antigen abnormal synchronization for leukemiamay have some value（CD34⁺CD7⁺, CD34⁺CD19⁺, CD34⁺CD11b⁺）.3.CD56and CD11b have improtant significance in the diagnosis and prognosisof M₅; Myeloid antigen and lymphoid antigen are positive in MAL, the curativeeffect of MAL is worse.