급성 백혈병에서 면역학적 표지자의 표현양상

Abstract

Background: Immunophenotyping is an important technique for the diagnosis and classification of acute leukemia, as well as French-American-British(FAB) classification on the basis of morphologic characteristics and cytochemistry. We evaluated the expression patterns of immunologic surface markers in acute leukemia. Methods: Peripheral or bone marrow leukemic cells from 75 leukemic patients(acute lymphoblastic leukemia, ALL 40 cases; children(26 cases), adults(14 cases) and acute myeloid leukemia, AML 35 cases; children(9 cases), adults(26 cases)) were studied. Monoclonal antibodies which were designed for two color direct immunofluorescence(IF) analysis with combination of fluoresceinisothiocynate(FITC) and phycoerythrin(PE) conjugated, CD10/CD19, CD20/CD5, CD3/CD22, CD7/CD33, HLA-DR/CD 13(Acute Leukemia Phenotyping Kit, Beckon Dickinson; BD, USA) were analyzed by flow cytometry. Results: Blasts from these patients could be classified as CALLA(+)B-ALL(26 cases, 65.0%), CALLA(-)B-ALL(6 cases, 15.0%), T-ALL(6 cases, 15.0%), biphenotypic ALL(2 cases, 5.0%). The positive expression rates were CDl9(100%), CD10(78.1%), CD22(75.0%) and CD20(50.0%) in B-ALL, CD7(100%), CD3(50.0%) and CD5(50.0%) in T-ALL and CD33(85.7%), CDl3(74.3%) in AML, respectively. The incidence of acute mixed lineage leukemia(AMLL) was 26.7% and leukocytosis, anemia and thrombocytopenia were frequently seen in AMLL. Conclusion: By the study of immunophenotyping we could more exactly diagnosed ALL and AML, as well as AMLL which was not exactly diagnosed by characteristics of morphology and cytochemistry only. Therefore the best method for the diagnosis of acute leukemia will be achieved by using of immunophenotyping and FAB classification on the basis of morphology and cytochemistry.