12例急性双系列白血病细胞形态学与免疫表型分析

摘要

Objective To investigate the relationship between cell morphology and immunophenotype of acute bilineage leukemia(aBLL).Methods A total of 12 aBLL patients were enrolled, and the marrow cell morphology and histochemistry staining were performed.The immunophenotype was detected, including HLA-DR, CD34, MPO, CD13, CD33, CD11b, CD117, CD14, CD64, CD3, CD4, CD7, CD10, CD19, CD20, CD22 and CD79a.Results There were not only some differences but also complementaries between FAB and immunophenotype classification of aBLL.Of the 12 aBLL patients, 6 cases were diagnosed by cell morphology as acute myeloid leukemia (AML) [M2 (4 cases) and M1 (2 cases)], 2 cases as acute mixed lineage leukemia (AMLL) and 4 cases as ALL-L2, respectively.The 12 cases were diagnosed by immunophenotype classification as aBLL, while 10 cases were myeloid-B lymphocyte mix (My-B), and 2 cases were myeloid-T lymphocyte mix (My-T).Conclusions aBLL is a rare type of leukemia.The complementarity between immunophenotype and cell morphology can effectively reduce the misdiagnosis and missed diagnosis of aBLL.%目的：探讨急性双系列白血病（aBLL）细胞形态学与免疫表型的关系。方法回顾分析12例 aBLL 患者的骨髓细胞形态、组织化学染色，同时进行免疫表型（HLA－DR、CD34、MPO、CD13、CD33、CD11b、CD117、CD14、CD64、CD3、CD4、CD7、CD10、CD19、CD20、CD22、CD79a）检测。结果12例 aBLL 患者 FAB 分型与免疫表型分型既有一定的差异性，同时也有较好的互补性。12例 aBLL 患者中，细胞形态学诊断为急性髓细胞白血病（AML）6例，其中4例为 M2、2例为 M1；2例诊断为急性混合细胞白血病（AMLL）；4例诊断为急性淋巴细胞白血病（ALL－L2）。免疫表型诊断为 aBLL 的12例中髓－B 淋巴细胞混合（My－B）10例、髓－T 淋巴细胞混合（My－T）2例。结论 aBLL 是一种少见类型的白血病，免疫表型与细胞形态学有一定的互补性，能有效降低 aBLL 的误诊率和漏诊率。