The Biological Characteristics And Significance Of Hyperleucocyte Acute Leukemia

Purpose : Discuss the biological characteristics, significance and treatment of hyperleukocytic acute leukemia.Method:1. patients, from Jan.1998 to June.2005 in Wuhan Union Hospital, were selected. 51 patients of HAL were selected as investigation objective, including 35 male and 16 female, from 2-71 years old. The median age was 19 years old. 28 patients of AML were selected, including 5 cases of M1, 7 cases of M2, 3 cases of M3, 3 cases of M4 and 10 cases of M5. 23 patients of ALL were selected, including 3 cases of L1, 20 cases of L2. 73 patients of NHAL were selected as contrast, including 40 male and 33 female, from 2-79 years old. The median age was 19 years old. 41 patients of AML were selected, including 8 cases of M1, 16 cases of M2, 9 cases of M3, 2 cases of M4 and 6 cases of M5. 32 patients of ALL were selected, including 5 cases of L1, 24 cases of L2 and 3 cases of L3.2. All the patients were received bone marrow aspiration cytology, immunophenotype, and some patients were received cytogenetic examination.3 Some clinical data were reviewed, including peripheral WBC count, Hemoglobin count, PLT count; bome marrow blasts count (M3, promyelocyte count ), hematocrit, resluts of immunophenotype , and results of cytogenetics. In HAL patients, times of leukapheresis, pretreatment method, the duration time to decrease the WBC to 50×109/L, chemotherapy method, duration time for bone marrow suppression after chemotherapy and CR rate after chemotherrapy were recorded. The differences of parameters in HAL and NHAL groups were compared so as to know the characteristics of HAL.Results:1.In bone marrow smear, erythroid lineage accounted for 1.00% and NHAL accounted for 3.25%. HAL group is significantly lower than NHAL group. This difference had statistical meaning.(P<0.05) .2. In AML, CD14 positive rate was 25.00% in HAL group and 4.90% in NHAL group. HAL group was significantly higher than NHAL group. This difference had statistical meaning.(P<0.05).3. In ALL, CD8 positive rate was 30.40% in HAL group and 3.10% in NHAL group. HAL group was significantly higher than NHAL group. CD22 positive rate was 30.40% in HAL group and 68.80% in NHAL group. cCD79a positive rate was 39.10% in HAL group and 65.60% in NHAL group. HAL group was significantly lower than NHAL group. This difference had statistical meaning.(P<0.05).4. 74.51% lineage antigen in HAL group was cross-expressed and 68.50% lineage antigen in NHAL group was cross-expressed. No statistical difference was found in this two groups.(P>0.05)5. CR rate in HAL was lower than NHAL.Conclusion:The following differences were existed between HAL and NHAL:1.HAL had more severe bone marrow supprresion than HAL.2.In AML, M5 was easier to occur hyperleukocytosis.3.In ALL, HAL had more likelihood to express T-lineage antigen than NHAL.4.Leukemia cells in HAL was in ealier differentiation state than NHAL group.5.HAL had bad prognosis.