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目的回顾分析186例儿童急性淋巴细胞白血病(acute lymphoblastic leukemia,ALL)免疫表型结果,以期了解儿童ALL免疫表型的特征,为临床诊断、微小残留病(minimal residual disease,MRD)的监测提供依据。方法采用多参数流式细胞术(multiparameter flow cytometry,MFC),利用CD45PE-cy5/SS设门,完成186例儿童ALL病人的免疫分型。结果在186例ALL中,B系ALL78．5％(146/186),T系ALLl9．3％(36/186),T/M混合型ALL1．1％(2/186),B/M混合型ALL1．1％(2/186)。白血病相关免疫表型(characterization of leukemia-associated immunotyping,LAIP)的出现频率为:B-ALL CD19+/CD10+/CD117+1．4％; CD19+/CD10+/CD13+25．3％;CD19+/CD10+/CD33+21．3％;CD19+/CD10+/CD2+5．5％;CD10+/CD34+/CD45±86．9％;CD19+/ CD34+/CD20+24．7％;CD19+/CD10++/CD45±67．1％;CD19+/CD10-/CD20-4．1％。T-ALL CD7+/CD13+/CD45±5．6％;CD7+/ CD33+/CD45±2．8％;TdT+/CD3+/CD45±100％;CDT++/CD2±/CD45±77．8％;CD7+/CD4+/CD3-16．7％;CD7+/CD8+/CD3- 16．7％。结论儿童B-ALL比率高于T-ALL,约为T-ALL的4倍,混合细胞白血病在儿童很少见。而且儿童ALL均具有独特的LAIP特征,因此免疫表型分析对于白血病的诊断和MR监测可提供非常客观的依据。
Objective To retrospectively analyze the immunophenotype of 186 children with acute lymphoblastic leukemia (ALL) in order to understand the characteristics of childhood ALL immunophenotype and provide evidence for the clinical diagnosis and monitoring of minimal residual disease (MRD) . Methods The multiparameter flow cytometry (MFC) was used to screen the immunophenotypes of 186 children with ALL using CD45PE-cy5 / SS. Results In 186 ALL cases, 78.7% of ALL patients (76/186) were ALL, 93.3% (36/186) of ALL patients and 1.1% (2/186) of T / M ALL patients. Type ALL1.1% (2/186). The frequency of appearance of leukemia-associated immunotyping (LAIP) was: B-ALL CD19 + / CD10 + / CD117 + 1.4%; CD19 + / CD10 + / CD13 + 25.3%; CD19 + / CD10 + / CD33 + 21.3%; CD19 + / CD10 + / CD2 + 5.5%; CD10 + / CD34 + / CD45 ± 86.9%; CD19 + / CD34 + / CD20 + 24.7%; CD19 + / CD10 ++ / CD45 ± 67.1% CD19 + / CD10- / CD20-4.1%. T-ALL CD7 + / CD13 + / CD45 ± 5.6%; CD7 + / CD33 + / CD45 ± 2.8%; TdT + / CD3 + / CD45 ± 100%; CDT ++ / CD2 ± / CD3-16.7%; CD7 + / CD8 + / CD3- 16.7%. Conclusions The rate of B-ALL in children is higher than that in T-ALL, which is about 4 times that of T-ALL. Mixed-cell leukemia is rare in children. And children with ALL all have unique LAIP features, so immunophenotyping provides a very objective basis for the diagnosis and MR monitoring of leukemias.