| Background：Acute myeloid leukemia is a hematopoietic stem cell malignantclonal disease, it has a high degree of heterogeneity. The current MICM classificationhas become an important means of diagnosis of acute leukemia. It is generallybelieved that the important factors affecting the prognosis of acute myeloid leukemiais mark of cytogenetics and molecular biology. But not all of the patients in theclinical work is able to detect the specific cytogenetic and molecular biologyinformation. Immunophenotype is according to the specific antigen of inside andoutside cells with monoclonal antibody for fine detection and judgment, so as to clearthe leukemia cell origin and differentiation stage, It can quantitatively analysis of alarge number of cells in a short period of time, thus the accuracy rate of diagnosis wasimproved greatly, make up the shortage of FAB type. More important is this method issimple and universal application, not only makes the typing diagnosis of leukemia ismore accurate, but also can provide reference for the judgment of clinical efficacy ofAML. This research retrospectively analyzed myeloid leukemia cells in flowcytometry results for51cases treated first AML patients, to explore the characteristicsof immunophenotype of adult acute myeloid leukemia and the clinical significance.Objective：Exploring the characteristics of immunophenotype of adult acutemyeloid leukemia and the clinical significance.Methods：From January2009through December2012,510untreated patieniswith denovo AML diagnosed in a single institute were enrolled in this study. Bonemarrow cell morphology and flow cytometry were performed in all patients. Theretrospective analysis of the clinical data of selected cases,including the patient’s age,FAB subtype, immunophenotyping. All patients received standard chemotherapy andto evaluate the rate of complete remission after2courses. Results judge leukemia cellsurface antigen positive rate of≥20%positive, compare the immunophenotype(CD11b, CD13, CD14, CD15, D33, CD64, CD117, MPO, CD4, CD7, CD19, CD34, CD56)complete remission rate between patients with positive and negative patientswhether there are differences.Rates were compared using the chi-square test, P <0.05indicates difference was statistically significant.Result：(1)51cases of newly diagnosed AML patients,26males (51.0%) and25females (49.0%), aged18-73years old, with a median age of44years old. FABclassification: M11cases, M218cases, M312cases, M410cases, M59cases, M61cases.(2)Expression of Myeloid antigen: the level of expression was followed byCD33(96.1%), CD13(94.1%),MPO(86.3%),CD117(82.4%),CD15(60.8%),CD64(45.1%),CD14(23.5%),CDllb(17.6%); Stem/progenitor cell antigen: CD34(53.0%); NKcell antigen: CD56(21.6%); Expression of lymphoid antigen: there are19patientswith lymphoid antigen expression of this group of materials, the expression rate of19/51(37.3%). An expression of lymphoid antigen in17cases (33.3%), two kinds oflymphoid antigen expression in2cases (3.9%). Lymphoid antigen expression by CD7is more common, specifically:CD7(19.6%),CD19(11.8%),CD4(9.8%).(3)CD14,CD64expression in M4, M5which is significantly higher than other subtypes. Highexpression of M3in patients with CD33, CD13, CD117, MPO and low expression oflymphoid antigen and CD34, CD11b had no expression.(4)The data of51cases ofacute myeloid leukemia patients receiving remission induction therapy,33patientsachieved complete remission, the complete remission rate was64.7%. CD34, CD7,CD56-positive group complete remission rate lower than that of CD34, CD7,CD56-negative group, the difference between the two groups was statisticallysignificant(P value were0.002,0.003and0.010). Ly+AML group complete remissionrate(31.6%) was lower than that Ly-AML group CR rate(84.4%), the differencebetween the two groups was statistically significant(P=0.000). CD34/CD7,CD34/CD33,CD34/CD117co-expression of the complete remission rate is lower than non-co-expression group, the difference was statistically significant (P=0.001).Conclusion：(1)CD33, CD13, MPO, CD117in subtypes of acute myeloidleukemia showed high expression and high specificity, Choose these antigenscontribute to the accurate diagnosis of acute myeloid leukemia. The positiveexpression of CD33, CD13, MPO and the negative expression of CD34, CD11b, Rare lymphoid antigen expression,the immunophenotype is specific to M3subtypediagnosis.(2) Immunophenotyping can better reflect the heterogeneity of leukemiacells which is a supplement to the bone marrow cell morphology. Ly+AML patientswith poor effect of chemotherapy, lymphoid antigen expression can be used as animportant indicator of judgment of clinical efficacy of AML.the expression of CD34,CD7, CD56and the co-expression of CD34/CD7, CD34/CD33, CD34/CD117wasnegatively correlated with judgment of clinical efficacy.(3) Flow cytometry is simpleand universal application, if the cytogenetic and molecular biology information ofAML patients can not be acquired in clinical work, we can assist diagnosis and judgclinical efficacy through the immunophenotype. |
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