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目的探讨首疗程未缓解急性白血病的免疫学特征,以指导选择合适的化疗方案,从而提高首疗程缓解率。方法回顾性分析58例首疗程经积极标准化疗的急性白血病患者的免疫学特征,其中24例未达完全缓解的为观察组,34例达完全缓解的为对照组。结果观察组的CD34阳性率明显高于对照组,差异有统计学意义(P=0.011)。观察组22例急性髓细胞白血病(AML)患者中,CD7阳性表达率明显高于对照组,差异有统计学意义(P=0.031),而CD9阳性率明显低于对照组,若除外CD9,观察组在抗原跨系列表达的阳性率为51.2%(13/24),对照组为2.9%(1/34),差异有统计学意义(P=0.000)。结论初治的急性白血病患者应根据细胞免疫学特征选择化疗方案,对于普通型的免疫学特征急性白血病,可选用标准的化疗方案,对于具有以下免疫学特征的急性白血病,如高表达CD34、跨系列表达(CD7+AML或伴其他淋系表达的AML、伴髓系表达的急性淋巴细胞白血病),应首选高强度的诱导化疗方案。
Objective To investigate the first course of treatment did not alleviate the immunological characteristics of acute leukemia to guide the choice of appropriate chemotherapy regimen to improve the first course of treatment response rate. Methods The immunological characteristics of 58 patients with acute leukemia treated with active standard chemotherapy were retrospectively analyzed. Among them, 24 patients who did not achieve complete remission were the observation group and 34 patients who achieved complete remission were the control group. Results The positive rate of CD34 in the observation group was significantly higher than that in the control group, with a significant difference (P = 0.011). The positive rate of CD7 in 22 patients with acute myeloid leukemia (AML) in the observation group was significantly higher than that in the control group (P = 0.031), but the positive rate of CD9 was significantly lower than that in the control group The positive rate of cross-expression of antigens in the group was 51.2% (13/24), while the control group was 2.9% (1/34), the difference was statistically significant (P = 0.000). Conclusions Patients with newly diagnosed acute leukemia should choose chemotherapy based on the characteristics of cellular immunology. For the common type of immunological acute leukemia, the standard chemotherapy can be used. For acute leukemia with the following immunological features, such as high expression of CD34, Serial expression (CD7 + AML or AML associated with other gonorrhea lines, acute lymphoblastic leukemia with myeloid lineage) should be the first choice of high-intensity induction chemotherapy.