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目的 分析最近两年来儿童急性淋巴细胞白血病 (ALL)的临床预后并探讨其免疫学 ,细胞遗传学特征以及原发性多药耐药的发生率。方法 总结 15 4例初治儿童ALL的完全缓解 (CR)率 ,同时运用免疫组织化学、细胞遗传学等方法对白血病细胞的生物学特征进行研究。结果 儿童初治ALL的平均CR率是 94.1% ,显著高于成人 (6 7.8% ) ;免疫分型中 ,同时伴髓系表达者占 18.5 % ,Ph染色体的阳性率是 4.8% ,两组频率均低于成人 ;二倍体的核型异常明显高于成人 ;儿童多药耐药表型的阳性率明显低于成人。结论 儿童ALL具有较为独特的细胞形态学、免疫学及细胞遗传学特征以及较低的原发性多药耐药发生率 ,这可能是儿童ALL预后良好的原因之一。
Objective To analyze the clinical prognosis of children with acute lymphoblastic leukemia (ALL) in recent two years and investigate the immunological and cytogenetic characteristics and the incidence of primary multidrug resistance. Methods The complete remission (CR) rates of 15 ALL children with ALL were summarized. The biological characteristics of leukemia cells were also studied by immunohistochemistry and cytogenetics. Results The average CR rate of children with newly diagnosed ALL was 94.1%, significantly higher than that of adults (6.88%). In immunophenotyping, 18.5% of patients with myeloid lineage were expressed, and the positive rate of Ph chromosome was 4.8% Were lower than adults; diploid karyotype abnormalities were significantly higher than adults; children with multi-drug resistant phenotype positive rate was significantly lower than adults. Conclusion Child ALL has unique characteristics of cell morphology, immunology and cytogenetics and low incidence of primary multidrug resistance, which may be one of the reasons for the good prognosis of children with ALL.