老年急性白血病的临床特点及免疫学表型的研究

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1、老年急性白血病的临床特点及免疫学表型的研究【摘要】　　本研究分析老年急性白血病临床特点及生物学特征。对经FAB确诊的104例老年AL的临床及生物学特征进行回顾性分析，同时以71例非老年AL为对照并进行比较。结果表明：①老年急性非淋巴细胞性白血病比例明显多于非老年急性非淋巴细胞性白血病比例，差别有统计学意义，本组老年ＡＭＬ缺如；②老年AL骨髓原始细胞中位数明显低于非老年组；③AML中，老年组CD14表达率明显高于非老年组CD14表达率，老年组CD15、CD117、CD38表达率低于非老年组CD15、CD117、

2、CD38表达率，差别均有统计学意义；④老年组急性淋巴细胞性白血病中CD19表达最常见，表达率为100%；⑤老年组与非老年组在系列抗原专一表达和交叉表达及CR率上差别无显著性；⑥老年组不良核型表达率高于非老年组，差异有显著性;⑦老年组完全缓解率为42.%，两年存活率为%，化疗相关死亡率为%，非老年组CR率为%，两组比较差异有显著性。结论：老年AL不良免疫分型CD14表达率较非老年组高，良好免疫分型CD15表达率低于非老年组。不良核型表达率高于非老年组，总体缓解率低，死亡率高，化疗耐受性差，预后差。【关键词】急性

3、白血病　老年急性白血病　临床特点　免疫表型ClinicalCharacteristicsandImmunophenotypeofAgedPatientswithAcuteLeukemiaAbstractInordertoanalyzetheclinicalcharacteristicsandbiologicalfeaturesofacuteleukemiainelderly,10acuteleukemiapatientsinelderlywereretrospectivelyanalyzedandcompar

4、edwith1acuteleukemiapatientsbelow0yearsold.Theresultsshowedthat:(1)theproportionofAMLintheagedgroupwashigherthanthatintheyounggroup,andthedifferencewasstatisticallysignificant,butAMLwasabsentintheagedgroup;(2)themedianofbonemarrowblastcellintheagedgroupwass

5、ignificantlylowerthanthatintheyounggroup;(3)inAML,thefrequentlyofCD1expressionwashigherintheagedgroupthanthatintheyounggroup,whiletheexpressionfrequenciesofCD15,CD117,andCD38wererespectivelylowerintheagedgroupthanthatintheyounggroupwhichwereforCD15,forCD17,

6、andforCD3respectively,andthedifferencewasalsostatisticallysignificant.(4)CD1wasmostfrequentlyexpressedinALLoftheagedgroupandthepositiveratewas100%;(5)therewasnosignificantdifferenceinexpressionofspeciallineageantigensandoverlappinglineageantigensbetweenthea

7、gedgroupandtheyounggroup;(6)theexpressionfrequencyofunfavorablekaryotypesintheagedgroupwashigherthanthatintheyounggroup,andthedifferencewasstatisticallyverysignificant(P＜）;(7)thecompleteremissionrateintheagedgroup%,2-yearsurvivalrateintheagedgroup%,andtreat

8、ment-relatedmortalityrateintheagedgroup%,whiletheCRrateintheyounggroup%,thedifferencewasstatisticallysignificant.ItisconcludedthattheexpressionfrequencyofCD1associatedwithunfavorableprognosisishigherin