The Study Of The Immunophenotype Of Adult Acute Leukemia In Qinghai Province

Object:1.To reveal the expression patterns of the immunophenotyping of adult acute leukemia(AL) in Qinghai province preliminarily.2.To explore the relationship between the immunophenotyping of adult AL and its clinical efficacy in this district.Method;90 cases of newly confirmed adult AL, collected from Affiliated Hospital of Qinghai University and People’s Hospital in Qinghai Province from Jan. 2010 to Sept. 2014, were detected by bone marrow cell morphology and multi-parameter flow cytometry. We analyzed the expression laws of the immunophenotyping of various kinds of adult AL. Then we gave them standardized chemotherapies based on the types of leukemia: acute myeloid leukemia(AML)(non-M3) was utilized DA/IA/HA program, AML-M3 was applied all-trans retinoic acid(ATRA)+ATO(arsenic trioxide) ±anthracycline±Ara-C for dual induction treatment, acute lymphoblastic leukemia(ALL) was adopted VDLP program, mixed acute leukemia(MAL) was used lymphoid or lymphoid-myeloid chemotherapy. Observing the clinic effects of the first chemotherapy, we analyzed the complete remission(CR) ratio beween the positive-expression and the negtive-expression of the immunophenotyping(myeloid and lymphoid markers, stem and progenitor cell markers, antigens cross the departments) of AL by comparison. Statistical software was put into use to handle and analyze the data, and it was considered significant statistically, if P value was below 0.05.Result:1.In the 92 cases of AL, preliminaryly diagnosed by morphology, there were 90 cases classified as AL based on the immunophenotypic characteristics of the surface or the cytoplasma of cells. Besides, 2 cases of AL were diagnosed as aggressive natural killer cell leukemia(ANKL) and primary natural killer cell leukemia respectively. Base on the statistical data of our group, the diagnosed result of morphology and immunophenotyping of the 16 cases of AL were discrepant. The consistency rate was 82.61%(76/92).2.The 68 cases of AML mostly expressed antigens of CD13, CD33, CD38, CD117, CD123, HLA-DR and MPO. CD14, CD15 and CD64 were contributed to distinguish M2 from M5. Some lymphocytic antigens were expressed in the 47 cases of AML(69.12%). CD56(30.88%) and CD4(25.00%) is common, which is highly expressed in M5, while CD7, CD19 and CD9 were rare.3.9 cases of M3 expressed CD13(100.00%), MPO(100.00%), CD13(88.89%) and CD117(88.89%), while the amout of HLA-D(22.22%) and CD34(11.11%) were remarkablely lower than other types.4.HLA-DR, CD19, CD10, CD22, CD123, c CD79 a and CD34 were often seen in 18 cases of B-ALL; 66.67% of B-ALL expressed myeloid antigens, which were mainly CD13 and CD33, followed by CD15 and CD11 b. 2 cases of T-ALL expressed CD3, 1 case expressed CD20, myeloid antigens and stem(progenitor)cell antigens were none.5.2 cases of MAL expressed myeloid antigens(CD13, CD14, CD15, CD33, CD64, CD117) and B antigens(CD19, CD22, c CD79a) simultaneously.6.The CR ratio of group CD15+ and group CD56+ were higher than group CD15- and group CD56-, the discrepancy were significant(P=0.025, 0.019); the CR ratio of group Ly+AML(non-M3) was slightly higher than group Ly-AML(P>0.05).7.The CR ratio of positive My+B-ALL was lower than negtive My—B-ALL(P=1.000).Conclusion:1.Immunophenotype is the necessary means for the diagnosis of AL, a supplement and correction for morphologic classification. In Qinghai province, the most common type of AML is M2, while M6 and M7 comes the least; the main type of ALL is B-ALL.2.CD33, MPO, CD13, and CD117 are highly expressed in AML, while the level of HLA-DR and CD34 are very low, which probably indicates that we could diagnose the patients as M3 bestially.3.The CR ratio of group CD15+ and group CD56+ are higher than group CD15—and group CD56—, which indicates that CD15 and CD56 may be related to the prognosis of AML.4.There are no difference between group Ly+AML(non-M3) and group Ly-AML(non-M3), which demonstrates that the lymphocytic antigens expressed in AML irrelevant to the prognosis.5.There are no difference between group My+B-ALL and group My-B-ALL, which demonstrates that the myeloid antigens expressed in B-ALL irrelevant to the prognosis.