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目的:报道新发现4例伴t(8;21)(q22;q22)易位的急性双表型白血病(biphenotypic acute leukemia,BAL),分析其细胞形态学、免疫表型、染色体核型分型及临床特征。方法:将4例伴t(8;21)(q22;q22)易位的BAL(A组),与随机挑选同期发现的伴其他克隆性染色体改变的BAL(B组)和伴t(8;21)(q22;q22)的M2b(C组)病例对照,对染色体核型分型及临床特点比较分析。结果:伴t(8;21)(q22;q22)易位的BAL特点如下:①无显著男女性别差异;②发病年龄较轻;③外周血白细胞计数不增高;④骨髓细胞形态学显示为粒细胞白血病,且原始细胞显著增多;⑤免疫表型均为B淋巴系和髓系共表达的BAL,CD34表达阳性,且为高表达;⑥染色体改变除t(8;21)(q22;q22)易位外,亦常见性染色体缺失,与(acute myeloid leukemia,AML)AML-M2b的特点相符;亦出现复杂染色体改变,符合BAL的特点。⑦对兼顾髓系和淋巴系的联合治疗方案反应较好,与B组的BAL类似,1例单用AML方案(MA)治疗者NR,后死亡。结论:报道新发现的一组伴t(8;21)(q22;q22)易位的BAL,提示此类患者的白血病细胞克隆起源可能较早。
OBJECTIVE: To report the changes of cell morphology, immunophenotype and chromosome karyotype in 4 newly diagnosed biphenotypic acute leukemia (BAL) patients with t (8; 21) (q22; q22) translocations. And clinical features. Methods: Four BAL (A group) patients with t (8; 21) (q22; q22) translocation were randomly divided into three groups: BAL (B group) 21) (q22; q22) of M2b (C group) case control, chromosome karyotypes and clinical characteristics of comparative analysis. RESULTS: The characteristics of BAL with t (8; 21) (q22; q22) translocations were as follows: ① There was no significant difference between men and women; ② The age of onset was younger; ③ The peripheral blood leukocyte count did not increase; ④ The morphology of bone marrow cells was Cell leukemia, and the number of primitive cells increased significantly.⑤The immunophenotypes were both BAL and CD34 co-expressed in B lymphatic system and myeloid. The expression of CD34 was high and the expression of CD34 was high. ⑥ The chromosome was changed except t (8; 21) (q22; q22) Translocations, but also common sex chromosome loss, and (acute myeloid leukemia, AML-M2b characteristics consistent; also complex chromosome changes, in line with the characteristics of BAL. ⑦ For both myeloid and lymphatic system combination therapy response is better, and B group similar to BAL, a single AML regimen (MA) treatment of NR, died. CONCLUSION: A newly reported group of BAL with t (8; 21) (q22; q22) translocations suggests that the origin of leukemic cell clones in these patients may be earlier.