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目的 探讨急性混合细胞白血病 (HAL)的实验室特征及其与诊断分型和临床治疗的相关性。方法 对 2 7例HAL住院患者的临床及实验资料进行回顾性分析。结果 HAL患者临床上易合并肝、脾、淋巴结肿大及各种浸润症状。外周白细胞数高 ,易合并重度贫血。免疫表型中双系列较双表型多见。诱导缓解治疗缓解率为 2 5 0 %。以兼顾急性淋巴细胞白血病 (ALL)和急性非淋巴细胞白血病 (AML)方案及针对ALL的方案缓解率高。形态学表现为髓系白血病 ,合并重度贫血者以及有细胞遗传学异常者化疗缓解率低 ;而免疫表型、外周血白细胞数、血小板是否正常、是否合并浸润症状对化疗有效率无影响。化疗后易合并肺部细菌和霉菌混合感染 ,预后差。结论 HAL病情凶险 ,临床有一定特点 ,但诊断应进行以免疫表型为主的MICM分型。形态学表现为髓系白血病 ,合并重度贫血者以及有细胞遗传学异常者诱导缓解治疗效果不佳。治疗应首选兼顾ALL和AML的方案或针对ALL的方案。
Objective To investigate the laboratory characteristics of acute mixed leukemia (HAL) and its relationship with diagnostic typing and clinical treatment. Methods The clinical and experimental data of 27 HAL patients were retrospectively analyzed. Results HAL patients clinically complicated with liver, spleen, lymph nodes and various infiltration symptoms. High number of peripheral white blood cells, easy to merge severe anemia. Immune phenotype in the dual series more than double phenotype. Induced remission treatment remission rate was 25%. In order to balance acute lymphoblastic leukemia (ALL) and acute non-lymphocytic leukemia (AML) programs and programs for ALL high remission. Morphological manifestations of myeloid leukemia, patients with severe anemia and cytogenetic abnormalities chemotherapy response rate is low; and immunophenotype, peripheral blood leukocytes, platelets are normal, whether the combination of infiltration symptoms have no effect on the efficiency of chemotherapy. Chemotherapy after the merger of lung bacteria and fungal mixed infection, the prognosis is poor. Conclusion HAL is dangerous and has some clinical features. However, the diagnosis should be based on immunophenotyping MICM typing. Morphological manifestations of myeloid leukemia, patients with severe anemia and cytogenetic abnormalities induced remission treatment ineffective. Treatment should be preferred both ALL and AML programs or programs for ALL.