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目的 研究儿童急性淋巴细胞白血病 (ALL)的MICM分型及其与治疗、预后的相关性。方法 采用细胞形态学检查、染色体R带或G带核型分析、流式细胞仪细胞免疫表型检测和套式逆转录聚合酶链反应 (RT PCR)检测TEL AML1、BCR ABL融合基因转录本。结果 在 16 0例儿童ALL中 ,76例为L1型 ,73例为L2 型 ,5例为L3 型 ,6例不能分类。在核型分析的 15 1例中 ,75例 (4 9 7% )有克隆性染色体异常。包括超二倍体 16例 ,假二倍体 12例 ,亚二倍体 2 6例 ,染色体易位 2 1例。后者包括t(4 ;11) 7例 ,t(9;2 2 ) 6例 ,其他少见易位 8例。进行过免疫表型分析的 12 8例中 ,6 4例 (5 0 0 % )为B系表达 ,38例 (2 9 7% )为T系表达 ,14例 (10 9% )为T、B混合表达 ,6例为B系、髓系混合表达 ,3例为T系、髓系混合表达 ,其他 3例。套式RT PCR检测到TEL AML1融合基因转录本 11例、BCR ABL融合基因转录本 2例。 12 5例ALL患儿分别接受DOLP(柔红霉素、长春新碱、左旋门冬酰胺酶、泼尼松或地塞米松 ) ,CODP(环磷酰胺、长春新碱、柔红霉素、泼尼松或地塞米松 )或COLP(环磷酰胺、长春新碱、左旋门冬酰胺酶、泼尼松或地塞米松 )方案治疗 ,其中 116例 (92 8% )获得完全缓解 (CR)。CR达 2年以上者 16例 ,1年以上者 2 8例 ,6个月以上者 17例。?
Objective To study the classification of MICM in children with acute lymphoblastic leukemia (ALL) and its relationship with treatment and prognosis. Methods The ABL fusion gene transcripts of TEL AML1 and BCR were detected by morphological examination, karyotype analysis of R band or G band, cellular immunophenotyping by flow cytometry and nested reverse transcriptase polymerase chain reaction (RT PCR). Results Among 160 ALL children, 76 were L1, 73 were L2, 5 were L3, and 6 were not classified. Of the 15 1 cases of karyotype analysis, 75 (497%) had clonal chromosomal abnormalities. Including 16 cases of hyperdiploid, 12 cases of pseudoduplex, 26 cases of sub-diploid and 21 cases of chromosomal translocation. The latter included t (4; 11) in 7 cases, t (9; 2 2) in 6 cases, and other rare translocations in 8 cases. Among the 12 8 immunophenotype analysis cases, 64 cases (500%) had B lineage, 38 (297%) had T lineage, and 14 (109%) had T, B Mixed expression, 6 cases of B line, myeloid mixed expression, 3 cases of T line, myeloid mixed expression, the other 3 cases. Nested RT PCR detected TEL AML1 fusion gene transcripts in 11 cases, BCR ABL fusion gene transcripts in 2 cases. 12 5 ALL children were treated with DOLP (daunorubicin, vincristine, levamisole, prednisone or dexamethasone), CODP (cyclophosphamide, vincristine, daunorubicin, Nisin or dexamethasone), or COLP (cyclophosphamide, vincristine, levospazinase, prednisone or dexamethasone) regimen, of which 116 (92.8%) achieved complete remission (CR). There were 16 cases with CR more than 2 years, 28 cases with more than one year and 17 cases with more than 6 months. ?