摘要 目的 探讨初治老年人急性白血病(AL)免疫学和细胞遗传学特征。 方法 对48例初治老年人AL采用间接免疫荧光技术进行免疫分型及R带或G带显带技术核型分析。 结果 形态学分型与形态学、免疫学、细胞遗传学(MIC)分型48例(93.8%)相符合，3例(6.2%)为杂合型急性白血病。48例老年人AL与58例非老年人AL比较，急性髓细胞白血病(AML)发生率高，而急性淋巴细胞白血病(ALL)发生率低(均为P<0.01)。7例老年人ALL中，6例为B-ALL。CD34、CD7、CD11b抗原在两组AML中表达阳性率相似。在老年组AML中，预后好的核型t(15；17)、t(8；21)及inv(16)发生率明显低于非老年组(P<0.05)；预后差的核型-5/5q^- 、-7/7q^- 、+8及ALL中Ph染色体有较高发生率。

结论 老年人AL具有独特的MIC特征，这可能是老年人AL预后不良的原因之一。

A study on the cytomorphological, immunological and cytogenetic features of acute leukemia in elderly

Qiu Huiying, Li Jianyong, Chen Zixing, etal. First Affiliated Hospital of Suzhou Medical College, Jiangsu Institute of Hematology,Suzhou 215006

Abstract Objective To studythe features of morphology(M) immunology(I) and cytogenetics(C) in elderly acute leukemia(AL). Methods Forty-eight elderly patients with AL were immunophenotyped byindirect immunofluorescence technique and cytogenetics were analysed by R-banding andG-banding technique. Results The conformity rate of morphological classification with MICclassification was 93.8%. Three cases (6.2%) were diagnosed as hybrid acute leukemia.Compared with 58 cases of non-elderly AL, the elderly showed higher incidence of AML andlower incidence of ALL (P<0.01). Six cases wereB-ALL. For acute myeloid leukemia (AML),the expressions of CD34, CD7, CD11b antigens weresimilar in two groups. Cytogenetically, in the elderly AML group the incidence of goodprognosis abnormalities including t(15;17), t(8;21), inv(16) was lower in elderly than inyoung patients (P<0.05),and there was higher rate ofpoor prognosis abnormalities such as -5/5q^- ,-7/7q^- ,+8(P>0.05), and Ph chromosome in elderly patients. Conclusions Theelderly AL had distinct MIC features which might contribute to the poor prognosis of thepatients.

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