Dissertation
Dissertation > Medicine, health > Oncology > Hematopoietic and lymphoid neoplasms > Leukemia > Acute leukemia

MICM Classification Results and Efficacy Analysis of110Patients with Acute Lymphoblastic Leukemia

Author LiuLei
Tutor BaiXiaoChuan
School Ningxia Medical University
Course Internal Medicine
Keywords Acute lymphoblastic leukemia MICM classification Curative effect
CLC R733.71
Type Master's thesis
Year 2013
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Objective To explore MICM classification and its correlation with curative effect ofacute lymphoblastic leukemia(ALL).Methods The flow cytometry instrument is performed to detect the immune phenotypein110Patients with Acute Lymphocytic Leukemia(ALL); The R-or-G banding technigue isperformed to detect karyotype in59Patients with Acute Lymphocytic Leukemia(ALL); Thereverse transcriptase polymerase chain reaction(RT-PCR) is performed to detect the fusiongene transcript in53Patients with Acute Lymphocytic Leukemia(ALL). And the results areanalyzed.Results Among B-ALL patient, positive rate of membrane antigen is expressed as follows:CD19>CD22>CD10>CD79a>CD20, The expression rate of CD19in T-ALL patients is also higher. Among T-ALL patients,positive rate is expressed as follows: CD3>CD7>CD5>CD8, The expression rate of CD7in B-ALL patients is also higher. The comparison with CR rate of B-ALL and T-ALL patients is not statistically significant and compared respectively with CR rate of the T/B double phenotypes of patients is also nostatistical significance. Follow-up for one year, the recurrence rates of B-ALL lower significantly than T-ALL, there are two cases of recurrence in T/B double phenotype patients. Among B-ALL patients, the CR rate of CD19is the highest, compared with the rest of the immune logo is statistically difference, in turn: CD19>CD10>CD20>CD22>CD79a. Recurrence rate is followed as: CD10>CD22>CD79a>CD20>CD19, the comparison of them has no statistical difference. Among T-ALL patients, The CR rate and recurrence rate of CD3~+、CD5~+、CD7~+is similar, the comparison of them has no statistical difference. The56.4%of patients expressed myeloid antigen at the same time (My~+-ALL), My~+-B-ALL are higher than My~+-T-ALL, the myeloid antigen of CD13, CD33are common. The CR rate of My~+-B-ALL is lower than My--B-ALL, and recurrence rate is elevated, the comparison of them is different. The CR rate of My~+-T-ALLis lower than My--T-ALL, the recurrence rate of My~+-T-ALL is higher than My--T-ALL, Among T/B-ALL patients, there are two patients of My~+-T/B-ALL is CR, two is recurrence, there are two patients of My--T/B-ALL is CR, no recurrence, CD34~+often isseen in B-ALL, compared with the CD34~+-B-ALL group and CD34~+-T-ALL group isstatistical significance. Compared with the patient of CD34~+-B-ALL and CD34--B-ALL, the CR rate is decreased and the recurrence rate is elevated, The comparison of them is different(P<0.05). Compared with the CR rate and recurrence rate of CD34~+-T-ALL and CD34--T-ALL is different, but no statistical significance. The detection rate ofnormal chromosome karyotype is higher than abnormal karyotype, mainly seen in B-ALL. Abnormal karyotype with t(9;22) and complex karyotype is the most common. t(9;22) is only seen in B-ALL. The remission rate of normal karyotype group is higher,compared with the t(9;22) group and complex karyotype group is statistical significance,and compared with recurrence rate of each group is no different, but t(9;22) groupand complex karyotype group is higher than the other two groups. The detection rateof fusion gene negative expression is higher than the abnormal gene. The BCR/ABL of abnormal gene is the most common genes, and seen in B-ALL, its CR rate is lower and recurrence rate is higher. Compared with is negative expression group statistical significance.Conclusion1. The source of B cell in acute lymphoblastic leukemia is common than Tcell.Among B-ALL patient,CD19is the highest expression rate, may be more sensitive indexfor diagnosis of B–ALL; CD22and CD79a may be more specific index for diagnosis of B–ALL; CD3may be more specific index for diagnosis of T–ALL.2. Among B-ALL patient,CD19~+has better prognosis, but CD79a~+has poor prognosis.3. ALL with myeloid antigenexpression,CD13is the highest expression rate.The remission rate of treatment of ALL (My~+-ALL) patients is low, easy to relapse and poor prognosis.4. CD34is often expressed in B-ALL,and the CR rate of CD34positive expression of ALL patient is lower, these patientseasily relapse and their lifetime is short.5. In chromosome detection, normal karyotype iscommon, has well prognosis. The t(9;22) of abnormal karyotype is the most common, and ithas poor prognosis. t(4;11) also has poor prognosis in ALL.The ALL patient with complexkaryotype has poor prognosis.6. The detection rate of abnormal fusion gene in ALL patientsis low, and BCR∕ABL is common,this group of patients easy to relapse, these patients’lifetime is short and their prognosis is poor.The long-term remission rate of fusion genenegative expression group is high, and its prognosis is well.The ALL patient expressed MLL∕AF4with poor prognosis.

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