摘要
目的初步探索三磷酸腺苷生物荧光肿瘤体外药敏检测(ATP bioluminescence-tumor chemosensitivity assay,ATP-TCA)技术在急性髓系白血病(acute myeloid leukemia,AML)中的临床应用价值。方法采集18例初治AML患者的骨髓或外周血,分离单个核细胞,应用ATP-TCA技术,观察体外白血病细胞对化疗药物的敏感性,并分析体外药敏结果、危险度分层及临床疗效三者之间的关系。结果 18例初治AML患者的白血病细胞在体外对8种化疗药物显示出不同的敏感性,有效率最高的是阿柔比星,无效率最高的是吡柔比星。在14例可进行疗效评价的初治AML患者中观察到蒽环类药物体外敏感性与临床疗效之间的完全相符率为78.6%,不同危险度分层患者之间的临床疗效(P=0.012)和生存时间(P=0.018)均有显著差异,高危组患者生存时间最短。结论 AML体外药敏检测结果与临床治疗反应之间具有相关性趋势,ATP-TCA可能是开展AML个体化化疗的一种有效的体外药物筛选方法,尤其是老年AML。
Objective To preliminarily explore the clinical value ofATP bioluminescence tumor chemosensitivity assay （ATP- TCA） in patients with acute myeloid leukemia （AML）. Methods Peripheral blood or bone marrow mononuclear cells separated from newly diagnosed AML specimens were tested in vi^o for cancer chemosensitivity to eight kinds of drugs by ATP-TCA, which was used for observing the susceptibility results in vitro and analyzing the relationships among the susceptibility results in vitro, risk stratification and clinical efficacy. Results Eighteen cases of AML patients displayed different sensitivities to these eight kinds of drugs in viro.Different drugs had different tumor growth inhibition ratio in vitro, of which the highest efficiency is aclarubicin and the highest inefficiency is pirarubicin. Fourteen cases of de novo AML patients were evaluable for clinical efficacy. Entirely consistent rate between the susceptibilityin vitro and clinical efficacy was 78.6%, according to the susceptibility results of anthracycline in chemotherapy regimens. Clinical efficacy （P=0.012） and survival time （P=0.018） in patients with three different groups of risk stratification were statistically significant. Patients in high-risk groups had the shortest lifetime. Conclusion The results of ATP-TCA assay were correlated well with clinical treatment responses. The assay may be an important and effective method for individual-based chemotherapy of AML, especially in elderly AML.
出处
《中国药物警戒》
2016年第3期132-137,共6页
Chinese Journal of Pharmacovigilance
基金
北京市卫生系统高层次卫生技术人才培养项目(2011-3-092)
首都医科大学基础临床合作研究基金(15JL07)
首都医科大学宣武医院英才培养计划
