Between October 1983 and May 1986, 17 cases of childhood acute lymphoblastic leukemia (ALL) were admitted to the General Hospital, Port of Spain, Trinidad. Fifteen of those cases were under 10 years of age, seven of whom presented with joint or bone pains. Boys outnumbered girls by almost 5:1 and the ethnic distribution showed a preponderance of patients of East Indian origin. At last follow-up (May 1989), the survival rate of the 15 under-10-year-old patients was 71%. Immunophenotype studies on nine of the 17 patients revealed six carrying T cell markers and three carrying markers suggestive of a pre-B phenotype. HLA tissue typing on 10 patients showed an enhanced frequency of the HLA-B40 antigen when compared with controls (p less than 0.05). This antigen was present in six of the patients typed and four carried the HLA-A2 and B40 antigens together, two of whom also carried the CW3 antigen and the other two carried untypable C antigens. Three of the four carrying HLA-A2 and B40 have died. Two of the three pre-B cases also carried the HLA-A2 and B40 antigens. HLA studies on three of the four families showed that HLA-A2 and B40 were on the same chromosome, i.e., a haplotype inherited from the mother in each case. None of the cases carried the HLA-B5 antigen although this antigen had a frequency of 37.8% in the control group (p less than 0.05). None of the controls with the HLA-B40 antigen carried the CW3 antigen. Further evidence of a disease association must await typing of the D locus antigens but current evidence would suggest an association between HLA-B40 and childhood ALL in Trinidad.

译文

在1983年10月和1986年5月之间,特立尼达西班牙港综合医院收治了17例儿童急性淋巴细胞白血病 (ALL)。其中15例年龄在10岁以下,其中7例出现关节或骨痛。男孩的人数几乎超过女孩5:1,种族分布显示出东印度裔患者占多数。在最后一次随访 (1989年5月) 时,15名10岁以下患者的生存率为71%。对17例患者中的9例进行的免疫表型研究显示,有6例携带T细胞标记物和3例携带提示B前表型的标记物。与对照组相比,10例患者的HLA组织分型显示HLA-B40抗原的频率增加 (p小于0.05)。该抗原存在于六名分型的患者中,四名同时携带HLA-A2和B40抗原,其中两名还携带CW3抗原,另外两名携带不可分型的C抗原。四个携带HLA-A2和B40中的三个已经死亡。三个前B病例中有两个还携带HLA-A2和B40抗原。对四个家庭中的三个家庭的HLA研究表明,HLA-A2和B40在同一染色体上,即在每种情况下均从母亲继承的单倍型。尽管该抗原在对照组中有37.8% 频率 (p小于0.05),但没有病例携带HLA-B5抗原。具有HLA-B40抗原的对照没有携带CW3抗原。疾病关联的进一步证据必须等待D基因座抗原的分型,但目前的证据表明特立尼达的HLA-B40与儿童之间存在关联。

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