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本文联合用细胞形态学、细胞化学、免疫学分型、免疫球蛋白重链(IgH)和T细胞受体(TCR)基因重排及电镜下过氧化物酶(EMPO)等多参数研究分析了14例急性未分化型白血病(AUL)。结果发现,AUL均缺乏典型的细胞形态和细胞化学特征,8例表达CD_9、HLA-DR抗原及CD19抗原或可检出IgH基因重排,属早期B细胞来源;4例形态学、细胞化学似ALL,无淋巴系抗原但表达1至多种粒系抗原或对EMPO阳性,属早期粒细胞来源,诊断为MPO~-AML或AML-MO。2例无任何抗原表达属于干细胞或细胞来源不明者。本文还分析了AUL的疗效并发现AUL表达CD19~+、CD9~+、DR~+者对ALL方案效果好。表达粒系抗原者对AML方案反应好,应推荐按其细胞标志选用化疗方案。AUL,CR期短,容易复发,应建议对AUL采用较强诱导化疗及骨髓移植以延长其生存期。最后,本文还讨论了AUL的诊断条件,并建议在Raghavachar诊断标准的基础上增加对CD19~-、CD22~-、CD13~-、CD33~-两点以严格AUL的标准。
In this study, the combination of cytomorphology, cytochemistry, immunological typing, immunoglobulin heavy chain (IgH) and T cell receptor (TCR) gene rearrangement and electron microscopy of peroxidase (EMPO) Cases of acute undifferentiated leukemia (AUL). The results showed that AUL lacked typical cell morphology and cytochemical characteristics. 8 cases expressed CD_9, HLA-DR antigen and CD19 antigen or detectable IgH gene rearrangements, which were of early B cell origin. Four cases were morphologically and cytochemically similar ALL, without lymphoid antigens but expressing one or more granulocyte antigens or positive for EMPO, is an early granulocyte source diagnosed as MPO -AML or AML-MO. 2 cases without any antigen expression belong to stem cells or cells of unknown origin. This article also analyzed the curative effect of AUL and found that AUL expression of CD19 ~ +, CD9 ~ +, DR ~ + of ALL program effect. Those who express the granulocyte antigens respond well to the AML regimen and should be recommended for their chemotherapy based on their cell markers. AUL, CR short, easy to relapse, should be recommended to AUL strong induction chemotherapy and bone marrow transplantation to extend its survival. Finally, this article also discusses the diagnostic criteria for AUL, and recommends that based on the Raghavachar diagnostic criteria, the criteria for strict AUL should be added to both CD19-, CD22-, CD13-, and CD33-.