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目的:本研究旨在探讨慢性淋巴细胞白血病(CLL)的实验室检查特点及特征性临床表现。方法:利用血细胞分析仪、流式细胞术、骨髓形态分析及R显带技术等对我院2002年4月-2012年4月收治的54例慢性淋巴细胞白血病患者的相关临床资料如血细胞计数、骨髓形态、染色体及免疫表型等进行检测并对结果进行回顾性分析。结果:CLL多发于老年患者,男性多见,中位年龄65岁(45-82岁)。大部分患者初诊时可出现典型的临床表现,37例(68%)患者初诊时淋巴结大,49例(91%)初诊时白细胞≥10×109/L,淋巴细胞绝对值≥5×109/L。13例(24%)初诊时肝脾或者脾大,17例(31%)初诊时乏力、消瘦。34(63%)例患者可见典型的CLL免疫表型,CD5、CD19.CD23、CD20的阳性率分别为90%、87%、72%、67%。32例患者染色体检测结果表明:13q-2例,17p-2例,11q-1例,+12有1例,6q-1例,t(14,16)1例。2例患者发生了自身免疫性溶血性贫血(AIHA)。1例患者发生了Richter转化,肿大淋巴结活检显示部分区域为弥漫性大B细胞淋巴瘤,其高表达CD20、CD19、CD22。结论:慢性淋巴细胞白血病具有其典型的临床表现、免疫表型及遗传学改变,并且对诊断及治疗有重要意义。
Objective: The purpose of this study was to investigate the laboratory features and clinical features of chronic lymphocytic leukemia (CLL). Methods: The clinical data of 54 patients with chronic lymphocytic leukemia from April 2002 to April 2012 in our hospital, such as blood cell count, Bone marrow morphology, chromosome and immunophenotype were detected and the results were retrospectively analyzed. Results: CLL was more common in elderly patients, more common in men, the median age of 65 years (45-82 years old). Most of the patients had typical clinical manifestations at initial diagnosis. Of the 37 patients (68%) who had newly diagnosed lymph nodes at the time of initial diagnosis, 49 (91%) had newly diagnosed leukocytes ≥10 × 109 / L and absolute lymphocyte count ≥5 × 109 / L . Thirteen patients (24%) were newly diagnosed with hepatosplenic or splenomegaly, and 17 (31%) had weakness and weight loss at the time of first visit. The typical CLL immunophenotypes were seen in 34 (63%) patients. The positive rates of CD5, CD19, CD23 and CD20 were 90%, 87%, 72% and 67%, respectively. Chromosome test results of 32 patients showed that there were 1 case of 13q-2, 17p-2, 11q-1, + 12, 6q-1 and t (14, 16) Two patients developed autoimmune hemolytic anemia (AIHA). Richter transformation occurred in one patient, and enlarged lymph node biopsy revealed diffuse large B-cell lymphoma with high expression of CD20, CD19 and CD22. Conclusion: Chronic lymphocytic leukemia has its typical clinical manifestations, immunophenotypes and genetic changes, and is of great significance for diagnosis and treatment.