急性髓性白血病完全缓解患者残留白血病细胞检测研究

本研究的目的是观察急性髓性白血病患者完全缓解后血液和骨髓中微小残留病变变化情况 ,并探讨微小残留病变在监测急性髓性白血病复发中的应用价值。用流式细胞术检测 3 3例化疗达完全缓解的急性髓性白血病患者血液和骨髓中残留白血病细胞 (residualleukemiccells,RLC)。结果显示 :急性髓性白血病完全缓解组和正常对照组外周血RLC分别为 ( 4 .75 18± 4 .15 3 7) %和 ( 0 .4 83 5± 0 .2 0 0 5 ) % ,二者比较有统计学差异 (P <0 .0 0 1) ;完全缓解组骨髓和正常对照组骨髓RLC分别为 ( 17.90 82± 2 0 .4 819) %和 ( 0 .72 85± 0 .2 2 0 9) % ,二者比较有统计学差异 ( P <0 .0 0 1) ;持续缓解组与复发组外周血RLC分别为 ( 2 .2 3 3± 1.5 92 3 ) %和 ( 10 .2 3 69± 9.4 714 ) % ;持续缓解组与复发组骨髓RLC分别为 ( 4 .779± 3 .0 3 3 6) %和 ( 3 8.0 685± 19.4 2 95 ) %。二组比较有统计学差异 (P <0 0 0 1)。结论 :应用流式细胞术检测残留白血病细胞对及时预测复发有重要意义 ,有利于在复发早期进行治疗。

Detection of Residual Leukemic Cells after Complete Remission of Patients with Acute Myeloid Leukemia

The aim was to study minimal residual disease (MRD) in blood and bone marrow after complete remission of patients with acute myeloid leukemia (AML) and explore the role of MRD in detecting relapse of acute myeloid leukemia. The blood and bone marrow samples from 33 AML patients who had been in complete remission were determined for residual leukemic cells (RLC) with flow cytometry. The results showed that RLC in AML group of complete remission was higher than that of normal group both in blood by (4.7518 +/- 4.1537)% vs (0.4835 +/- 0.2005)% and bone marrow by (17.9082 +/- 20.4819)% vs (0.7285 +/- 0.2209)%, while the RLC in relapsed group was higher than that in non-relapsed group both in blood by (2.233 +/- 1.5923)% vs (10.2369 +/- 9.4714)% and bone marrow by (4.779 +/- 3.0336)% vs (38.0685 +/- 19.4295)%. In conclusion, early detection of leukemic residual cells with flow cytometry contributes to treatment of relapse in time.