The Analysis Of Immunophenotype In115Patients With Acute Lymphocytic Leukemia And Clinical Significance

Objective：Acute lymphoblastic leukemia（ALL） is a malignant diseasecharacterized by the accumulation of lymphoblasts. Adults and children withALL patients have different prognosis and different biological characteristics.To provide some reference in clinical diagnosis, prognosis and therapy,this experiment analysed and compared the immunophenotype of adults andchildren newly diagnosed acute lymphoblastic leukemia.Methods：1Immunophenotype of leukemia cells from115patients (62adults,53children) with newly diagnosed ALL were detected by flow cytometry (FCM),compared the differences between adults and children ALL patients.2The bcr/abl fusion gene from96patients with ALL were assayed byreverse transcription polymerase chain reaction (RT-PCR), and therelationships between bcr/abl fusion gene and the immunophenotype of ALLwere explored.3Statistical analysis was performed using SPSS13.0. Heterogeneity wasassessed with chi-square statistics.Survival analysis were obtained using theKaplan-Meier method.Results：1There were94cases (81.74%) of B-ALL,16cases (13.91%) of T-ALL,and5cases (4.35%) of T/B mixed type;2T-ALL subtype was higher in male group than that in female group,there was no significant difference between two groups of B-ALL subtype.3The positive rate of CD79a in adults and children were95.35%and100%respectively, the positive rate of CD19in adults and children were93.18%and97.87%, respectively; the positive rate of CD3in adults andchildren were100%and83.33%, respectively;the positive rate of CD7in adults and children were70%and100%, respectively. The expression ofmyeloid antigen (such us CD34，TdT，MPO, CD33, CD15, CD64) in adultswere higher than that in children,the expression of CD13and CD117in adultswere less than that in children, but without statistical significance.4The positive rate of CD10in adults ALL patients was69.49%（41/59）,less than that in children ALL patients86.67%（39/45）,the difference wasstatistically significant (P=0.039).5The positive rate of myeloid antigen expression in CD34+group ofadults was37.21%（16/34）,while in CD34-group was17.65%（3/17）; Thepositive rate of myeloid antigen expression in CD34+group of children was42.86%（12/28）,while in CD34–group was16.67%（2/12）, The positiverate of myeloid antigen expression in CD34+group was higher than that inCD34-group (P=0.032); The mean disease-free survival (DFS) of CD34-group and CD34+group was11.24months and5.58months respectively. theDFS of adults patients with CD34-group was significantly higher than that inCD34+group(P=0.029).6The positive rate of CD11b in adults ALL patients was higher than thatin children ALL patients. The complete remission rate of the CD11b-groupwas higher than that of the CD11b+group, without statistical significance.Theincidence rate of extramedullary infiltration in CD11b+group and CD11b-group was50%(5/10) and7.5%(3/40), respectively. CD11b+patientswere more likely to occur extramedullary infiltration than that in CD11b-group.7The complete remission (CR) rate of CD64+group were higher thanthat in CD64-group.(P=0.037).896ALL patients were detected bcr/abl fusion gene,30cases werebcr/abl+，including26cases of B-ALL (86.67%）．4cases of T-ALL(13.33%),most of the immune phenotype come from the B lineage,the positiverate of bcr/abl in adults was38.46%,higher than that in children22.73%.Thepositive rate of myeloid antigen (CD33) expression in bcr/abl+group was36.67%, significantly higher than that in bcr/abl-group13.64%(P=0.010). 9The mean disease-free survival of children and adults was25.29months and7.2months, respectively.The DFS in children ALL patients wassignificantly higher than that in adults group (P=0.000).Conclusion：1There were some differences of immunophenotype between adults andchildren ALL patients: the positive rate of CD10in adults ALL patients is lessthan that of children ALL patients; The positive rate of myeloid antigenexpression in CD34+group is higher than that in CD34-group; The positiverate of CD11b in adults ALL patients is higher than that in children ALLpatients. The positive rate of myeloid antigen (CD33) expression in bcr/abl+group is significantly higher than that in bcr/abl-group.2There is an association between the immunophenotype and prognosis inALL patients: CD11b+patients are more likely to occur extramedullaryinfiltration than that in CD11b-group; the DFS of adults patients with CD34-group is significantly higher than that in CD34+group; The completeremission (CR) rate of CD64+group are higher than that in CD64-group.3The differences in immunophenotype may be one of the reasons ofdifferent prognosis between adults and children ALL patients.