Clinical Study Of Adult Acute Leukemia According To Morphology,Immunology And Cytogenetics

Objective: To explore the clinical significance of morphology, immunology and cytogenetics (MIC) indiagnosis, treatment and evaluated prognosis of adult acuteleukemia(AL) .Method: 42 adult cases diagnosed initially as AL were analyzed with MIC. Morphology, immunology were examined by FAB and indirect immunofluorescence method. G banding technique was used for analysis of karyotype.Result: 41 of 42 cases were diagnosed reliably by morphology. 6 cases were acute lymphoid leukemia (ALL) and 35 cases were acute myeloid 1 eukemia(AML). 85.7%(30/35) of AML expressed CD13 and/or CD33. 60%(6/10) of M5 expressed CD14. 14.3%(5/35) of AML expressed lymphoid lineage-associated antigens (ly+-AML) and 8.6%(3/27) of AML expressed CD7. 1 of 6 ALL expressed myeloid lineage-associated antigens(My+-ALL). One case expressed CD9 and other expressed HLA-DR, CD34 only , no myeloid or lymphoid antigens expressed. One case expressed CD10, CD19, CD33, CD14, CD15 was diagnosed hybrid acute 1eukemia (HAL). The conformity rate of cytomorphologic classification with immunologic classification was 95%. 57.1%(24/42) of patients in this group showed abnormality in cytogenetics. t(15;17) occurred in 7/9 cases of M3. t(8;21) occurred in 3/10 cases of M2. The complete remission (CR) rate in CD34--AL is higher than CD34+-AL. The CR rate that CD33/CD13 > 1 in AML is higher than CD33/CD13 < 1 in AML (P<0.05) . The CR rate in normal cytogenetics is higher than abnormal cytogenetics. Patients with t(15;17) showed the better therapeutic effect thanother abnormal karyotype. The patients with white blood cell >100X109/L manifested the poor.Conclusion: Morphology is the basic method in diagnosis of AL. Immunology and cytogenetics can improve the correct rate of diagnosis , and be benefical to personalized therapy. It is showed that MIC classification is more helpful for diagnosis of AL and its subset, and provided an experimental evidence for personalized treatment and evaluated prognosis with AL.