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目的探讨急性混合细胞白血病的临床特征及诊治。方法根据骨髓细胞形态学、细胞化学染色和免疫表型结果诊断急性混合细胞白血病,采用DVCP方案、DVLP方案或DOAP方案化疗并根据骨髓缓解的情况评价疗效。结果11例患者临床表现为头晕乏力伴低热、胸骨压痛、淋巴结肿大、脾大、肝大、皮肤浸润等,所有患者骨髓增生明显活跃,近半数患者属高白细胞白血病。10例患者进行了免疫表型分析,其中B-Ly+/My+双表型8例、T-Ly+/My+双表型和B+T-Ly+/My+型各1例。采用DVCP方案、DVLP方案化疗7例,CR率42.9%,4例采用DOAP方案化疗,CR率50.0%。结论急性混合细胞白血病以B淋巴细胞系和髓系两系抗原共同表达者最多,临床分型诊断复杂,治疗缓解率低,预后差。
Objective To investigate the clinical features, diagnosis and treatment of acute mixed cell leukemia. Methods Acute mixed-cell leukemia was diagnosed according to morphology, cytochemical staining and immunophenotyping of bone marrow cells. The efficacy of DVCP, DVLP or DOAP chemotherapy was evaluated according to the bone marrow remission. Results The clinical manifestations of 11 patients were dizziness, weakness accompanied with fever, sternal tenderness, swollen lymph nodes, splenomegaly, hepatomegaly, skin infiltration and so on. All the patients had active bone marrow hyperplasia, and nearly half of them were high leucocytic leukemia. Immunohistochemical analysis was performed in 10 patients, including 8 cases of B-Ly + / My + double-phenotype, 1 case of T-Ly + / My + double and B + T-Ly + / My +. In the DVCP regimen, 7 cases were treated with DVLP chemotherapy, with a CR rate of 42.9% and 4 cases treated with DOAP regimen with a CR rate of 50.0%. Conclusions Acute mixed-cell leukemia has the most common expression of B lymphocyte lines and myeloid two-line antigens, the clinical classification is complicated, the treatment response rate is low and the prognosis is poor.