Immunophenotype and Prognosis in 510 Patients with Acute Myeloid Leukemia: A Single-Center Study
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摘要: 目的：探讨急性髓系白血病（AML）免疫表型特点及其与预后的相关性。方法：采用单克隆抗体四色直接免疫荧光标记AML骨髓细胞行流式细胞仪检测其免疫表型，回顾分析AML患者骨髓细胞免疫表型特点，并分析AML（除外M3）免疫表型与预后的关系。结果：510例AML免疫表型各抗原表达阳性率（以荧光阳性细胞 ≥ 20%为表达阳性）情况：CD13（86.3%）、CD33（79.4%）、HLA-DR（66.9%）、CD34（58.9%）、CD117（55.4%）、CD64（45.8%）、CD7（29.2%）、CD11b（23.4%）、CD56（18.9%）、CD10（12.5%）、CD15（11.6%）、CD2（8.7%）、CD19（8.5%）、CD14（8.4%）。M3患者CD34、HLA-DR阳性率显著低于非M3患者（P<0.01）。在AML（非M3）患者中，CD10、CD11b表达阳性或CD13、CD34高水平表达（以荧光阳性细胞 ≥ 50%为表达阳性）的患者CR率显著降低（P<0.05）；CD13和CD34高水平表达和CD13/CD34共表达的患者中位生存期显著缩短（P<0.05）。结论：CD13、CD33、HLA-DR、CD34、CD117是AML最常见的表达阳性抗原，CD10、CD11b、CD13及CD34的表达状况与AML（非M3）患者预后相关。免疫表型分析不仅有助于疾病的诊断，而且对急性髓系白血病的预后判断有着重要的价值。Abstract: Objective: To investigate the immunophenotype characteristic of acute myeloid leukemia(AML) and reveal the correlation of prognosis with the immunophenotype.Method: Immunophenotyping was performed in AML patients by multicolor flow cytometry. Correlation of immunophenotype with prognosis was analyzed in AML patients excluding APL cases.Result: The myeloid lineage antigens positive expression(expressed by more than 20% of the blast cells) in 510 AML patients:CD13 was detected in 86.3% of evaluable cases,CD33 in 79.4%,HLA-DR in 66.9%,CD34 in 58.9%,CD117 in 55.4%,CD64 in 45.8%,CD7 in 29.2%,CD11b in 23.4%,CD56 in 18.9%,CD10 in 12.5%,CD15 in 11.6%,CD2 in 8.7%,CD19 in 8.5% and CD14 in 8.4%.CD34 and HLA-DR positive expression percentage were significantly lower in APL patients(P<0.01).Patients with AML(excluding APL cases) blasts positive for CD10 and CD11b or high level expression(expressed by more than 50% of the blast cells) for CD13 and CD34 had significantly lower CR rates(P<0.05,respectively).The OS was significantly shorter in patients either with high level expression of CD13 or CD34,or expressing both CD13 and CD34 (P<0.05,respectively).Conclusion: AML patients general expressed positive antigens with CD13,CD33,HLA-DR,CD34 and CD117.CD10,CD11b,CD13 and CD34 might be associated with the prognosis of the patients with AML(excluding APL).Immunophenotyping might be not only helpful for diagnosis but also of important significance for prognosis in AML patients.
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Key words:
- prognostic factor /
- immunophenotype /
- acute myeloid leukemia /
- flow cytometry
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