| Objective: Analysied the immunophenotype of adult acute leukemia and the significance of CD44, CD87, CD123 expression in acute leukemiaMethods:1. 342 newly diagnosed patients with AL were enrolled from Jan. 2010 to Dec.2013 in the study. Analyzed the clinical data in selected cases, including patient’s sex, age, FAB subtype, immunophenotyping. All patients received standard chemotherapy and the rate of complete remission after 2 courses were evaluted. The cutoffs of leukemia cluster of differentiation antigen was more than 20% as positive, The relationship between the percentage of cluster of differentiation and complete remission rate of AL were analysied, The pearson chi-square test and logistic regression were used to analyze the raleationship between the patient’s clinical data and complete remission, p<0.05 indicated statistically significant.2. AL patients who were diagnosed in our hospital from Oct. 2014 to Apr. 2015 were detected by flow cytometry with the CD44, CD87 and CD123 antigen.Results:1. The general situation of the 342 cases acute leukemia patients: there were 248 cases of AML, 92 cases of ALL and 2 cases of biphenotypic leukemia in the 342 cases of newly diagnosed AL patients which included 186 males and 156 females, aged 7-88 years old with a median age of 42 years old. 144 patients were excluded which did not accord with the inclusive criteria. In total, 198 cases finished the standard chemotherapy and the results were evaluted, 140 cases achieved complete remission with 92 cases of AML and 48 cases of ALL.2. The antigen expression and prognosis of AML: ① The antigen profiles of AML patients: The myeloid antigen in the 248 patients of AML was as follow, common expression: CD13, CD117, CD33, MPO and CD64. Stem or progenitor cell antigen: CD34, non-specificity antigen: CD38 and HLA-DR, NK cell antigen CD56.. Lymphoid antigen expressed in 120 cases, which include one antigen in 108 cases, two antigens in 12 cases, and the common lymphoid antigen expression is CD9, the next is CD7.② The prognosis of AML patients: The complete remission rate of CD9-positive group is higher than that of CD9-nagative group, the difference between the two groups is statistically significant(P value is 0.000).While the complete remission rate of CD7, CD34, CD56 and HLA-DR-positive patients are lower than that of negative group, the difference between the two groups was statistically significant(P value were 0.000,0.000,0.012,0.001 respectively), the results show that the expression of CD7, CD34 and HLA-DR negatively influence the CR rate of AML patients while the expression of CD9 has positively effection. The EFS in CD7, CD34 and HLA-DR positive patients are obviously shorter than that of negative, and the expression of CD9 is opposite effection. the antigen of CD7 and CD34 are always co-expression.3. The antigen expression and prognosis of ALL: ① The antigen profiles of ALL patients: the total patients are 92 patients which include Multi T and B ALL 2 case and biphenotypic leukemia 2 case. B-ALL has 72 cases and the common antigen expression is as follow: CD22, CD19, HLA-DR, CD9, cCD79 a, CD10, CD34, CD38 and CD56. T-ALL has 18 cases and the common antigen expression include: CD38, CD7, CD5, cCD3, CD2, CD34, CD8, CD4 and CD3. Myeloid antigen express 22 cases and the primary is CD13.② The prognosis of ALL patients: The complete remission rate of CD9-positive group was higher than that of CD9-nagative group, the difference between the two groups was statistically significant(P value was 0.022).4. The expression of CD44, CD87, CD123 in AL and prognosis: ① The general situlation of AL patients: there are 40 untreated patients with AL expresses less than one antigen of CD44, CD87 or CD123, 10 cases of B-ALL, 30 cases of AML, 16 males and 24 females, aged 23-76 years old with median age of 51 years old,.② The expression of the antigen: the expression of CD44 and CD87 in AML are higher than that in B-ALL, the difference between the two groups is statistically significant(P value was 0.000,0.009 respectively), CD87 only express in AML.③ The prognosis of AL: The complete remission of CD87-positive group rate is higher than that of CD87-nagative group, the difference between the two groups is statistically significant(P value was 0.038). In the patient’s sex, the expression of CD44, CD87 and CD123, the expression of CD44 and CD87 are risk factors to the rate of CR. The expression of CD123 and CD44 are negative correction.Conclusion:1. The high expression and high seneitivity of AML are CD13, CD33, CD117, and MPO. The CD9 highly express in M3 has positively prognosis while CD7, CD34 and HLA-DR are negative effection. The antigen of CD7 and CD34 are always co-expression.2. CD22, CD19 and cCD79 a are high specificity symbol in the diagnosis of B-ALL, CD7 and CD5 are high sensitive symbol and cCD3 is specificity one in T-ALL. The expression of CD9 is related to positively prognosis.3. CD44, CD87 has higher expression in AML than that of ALL. CD87 is a specificity symbol of AML. CD44 and CD87 are related to poor prognosis of leukemia, the expression of CD123 and CD44 are negative correction. |
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