Objective: To explore the clinical and survival significance of CD20 positive adult patients with B-lineage acute lymphoblastic leukemia (B-ALL).
Methods: The clinical features and survival of 168 adult patients with B-ALL diagnosed and treated in our department from May 2007 to July 2011 were analyzed retrospectively, 58 expressed CD20 and 110 not.
Results: The sex, distribution of age, anemia, thrombocytopenia, infiltration of liver, spleen and lymph nodes, the expression of myeloid lineage marker, incidence of Ph chromosome, complete remission within 4 weeks showed no significant differences in CD20 positive and negative groups (P>0.05); median white blood cell count at diagnosis and the rate of patients with high white blood cell count in CD20 positive group were 19.2×10⁹/L and 37.9% respectively, which were significantly higher than those of 6.93 × 10⁹/L and 20.9% in CD20 negative group (P<0.05); cumulative incidence of relapse between two groups showed significant difference (P<0.05); multivariable analysis for overall survival and progress-free survival identified CD20 positivity as independent predictor.
Conclusion: The expression of CD20 in adult patients with B-ALL appeared to be associated with high white blood cell count and poor prognosis.
目的: 分析CD20在成人急性B淋巴细胞白血病（B-ALL）患者中的表达及CD20阳性B-ALL患者的临床特点和预后。
方法: 回顾性分析郑州大学附属肿瘤医院血液科2007年5月至2011年7月收治的168例初治成人B-ALL患者，其中CD20阳性58例，阴性110例。对比分析两组患者的临床特点和生存情况。
结果: CD20阳性与阴性组在性别、年龄分布及贫血、血小板减少、肝脾或淋巴结肿大、髓外浸润、Ph染色体阳性、髓系抗原表达、早期死亡、高危患者比例方面差异均无统计学意义（P值均>0.05），CD20阳性组患者初诊时中位白细胞计数（19.2×109/L）和高白细胞计数患者比例（37.9%）明显高于CD20阴性组（6.93×109/L和20.9%），差异有统计学意义（P值均<0.05）；两组诱导缓解治疗4周完全缓解率分别为78.6%和76.9%，差异无统计学意义（P>0.05），3年累积复发率分别为59.3%和42.5%，差异有统计学意义（P<0.05）。多因素分析显示CD20阳性是影响患者总生存（P=0.004）和疾病无进展生存（P=0.001）的独立预后不良因素。
结论: CD20阳性表达与成人B-ALL患者外周血白细胞计数相关，且CD20阳性者预后不良。