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目的观察单克隆B细胞增多症(MBL)与慢性淋巴细胞性白血病(CLL)的关系。方法调查1508例正常血细胞计数,年龄61～80岁和2002例淋巴细胞增多症(>4000/mm3)患者,应用流式细胞仪检测分析。结果正常细胞计数组中单克隆CLL表型B细胞者75例(5.0%),淋巴细胞增多症病例中280例(14.0%),在淋巴细胞增多的研究对象中,30%的患者进展为CLL,10%的患者需要化疗。随访5年间,35%的患者死亡,但死于CLL者仅6例。年龄68岁以上和低血红蛋白水平可预示死亡危险性增加。结论在一般人群中和在淋巴细胞增多患者中CLL表型的细胞,同慢性淋巴细胞白血病细胞有共同的特点。这一发现提示有CLL表型的单克隆B淋巴细胞增多者应加强监测,必要时应进行治疗。
Objective To investigate the relationship between monoclonal B cell polycythemia (MBL) and chronic lymphocytic leukemia (CLL). Methods 1508 patients with normal blood count, age from 61 to 80 years and 2002 patients with lymphocytosis (> 4000 / mm3) were investigated by flow cytometry. Results 75 (5.0%) of monoclonal CLL phenotype B cells and 280 (14.0%) cases of lymphocytosis were found in the normal cell count group. Thirty percent of patients with lymphocytosis progressed to CLL , 10% of patients need chemotherapy. During the 5 years of follow-up, 35% of the patients died, but only 6 died of CLL. Aged over 68 and low hemoglobin levels may indicate an increased risk of death. Conclusion CLL phenotype cells in the general population and in patients with lymphocytosis share common features with chronic lymphocytic leukemia cells. This finding suggests that mononuclear B lymphocytes with CLL phenotype should be monitored intensively and should be treated if necessary.