慢性髓性白血病的细胞危象:免疫表型分析

Akanksha Singh, Anurag Singh, S. Kanaujia, R. Kushwaha, U. Singh
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摘要

研究背景与目的:根据世界卫生组织对血液淋巴样肿瘤的分类,未经治疗的慢性髓性白血病分为慢性期和母细胞危象两个不同的阶段。慢性髓系白血病母细胞危象中的母细胞可以表达髓系、淋巴系、双表型、单核细胞、巨核细胞和红系表型。母细胞群体的免疫表型决定了慢性髓系白血病-母细胞危象患者对治疗的反应,因此需要流式细胞术检查。本研究的目的:评估流式细胞术在慢性髓系白血病-母细胞危象中的免疫表型结果。材料和方法:在印度勒克瑙乔治国王医科大学病理科(2017-2021)进行了为期五年的回顾性描述性分析。分析患者外周血及骨髓抽吸标本。检索临床、血液学和免疫表型数据。流式细胞术样品采用标准化的“赖氨酸-染色-洗”方法制备。结果:本科5年来共收集到43例慢性髓系白血病原细胞危象。研究人群平均年龄为39.62±14.86岁。男性24例,女性19例。骨髓母细胞危象27例,b淋巴母细胞危象14例,混合表型急性白血病2例。结论:确定慢性髓系白血病患者的母细胞谱系至关重要,因为非典型母细胞表型的存在影响疾病的治疗和预后。
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Blast crisis in chronic myeloid leukemia: An immunophenotypic analysis
Background and Aim of Study: There are two different phases of untreated chronic myeloid leukemia – chronic phase, and blast crisis – according to the World Health Organization classification of Hematolymphoid tumors. The blast cells in the chronic myeloid leukemia blast crisis can express myeloid, lymphoid, bi-phenotypic, monocytic, megakaryocytic, and erythroid phenotypes. The immunophenotype of blast population determines how chronic myeloid leukemia – blast crisis patients respond to treatment, hence flowcytometric examination is required. The aim of the study: to assess immunophenotyping outcomes of flowcytometry performed on the chronic myeloid leukemia – blast crisis. Material and Methods: A five-year retrospective descriptive analysis was carried out in Pathology Department at King George’s Medical University Lucknow, India (2017-2021). The patient’s peripheral blood and bone marrow aspirate samples were analyzed. Clinical, hematological, and immunophenotypic data were retrieved. The flow cytometry samples were prepared using the standardized “lyse-stain-wash” method. Results: A total of 43 cases of chronic myeloid leukemia – blast crisis were retrieved from the departmental archive in 5 years. The mean age of study population was 39.62±14.86 years. There were 24 males and 19 females. 27 patients were diagnosed with myeloid blast crisis, 14 cases of B-lymphoid blast crisis and 2 cases of mixed phenotypic acute leukemia. Conclusions: Identification of the blast lineage of patients with chronic myeloid leukemia – blast crisis is crucial since the existence of atypical blast phenotypes influences the disease treatment and prognosis.
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