摘要
目的:探讨急性白血病患者化疗后感染初始体温峰值与粒细胞缺乏持续时间之间的相关性及其潜在机制。方法:本研究纳入单中心行巩固化疗的粒缺感染的CR1期急性白血病患者111例,回顾性分析感染初期体温峰值与粒细胞缺乏持续时间之间的相关性,以及不同体温峰值患者血清中IL-6水平的差异。建立单细胞体外培养体系及检测体内EdU掺入率,分析IL-6对小鼠造血干/祖细胞的作用。结果:本研究纳入的111例粒细胞缺乏感染患者中,44例患者体温低于38℃,其粒细胞缺乏持续时间9.5±3.69 d;高于38℃的患者(67例),其粒细胞缺乏时间为7.33±4.20 d,2组间具备统计学差异(P=0.006)。EdU检测显示,EdU掺入阳性的造血干/祖细胞增多同时,IL-6水平在不同初始体温峰值的患者中具有显著性差异(P<0.05)。动物实验结果显示,IL-6在体外及体内均可促进小鼠造血干/祖细胞的增殖。结论:对于粒细胞缺乏感染患者,初始体温峰值低于38℃,则化疗后粒细胞缺乏持续时间延长概率增加,其机制可能与促炎症因子促进造血干/祖细胞增殖有关。
Objective：To investigate the relationship between early peak body temperature and neutropenia duration and its potential mechanism.Methods： A total of 111 patients with CR1 phase acute leukemia（ AL） with neutropenia infection were enrolled in this study.The relationship between early peak body temperature and neutropenia duration was analyzed retrospectively,and the IL-6 serum level in patients with different peak of body temperature was detected,and the single cell culture system in vitro was established,the incorparation rate of EdU in vivo was detected,and the effect of IL-6 on mouse hematopoietic stem cells/progenitor cells was analyzed.Results： Out of 111 patients with nentropenia,the body temperature 38℃ and the neutropenia duration 9.5 ± 3.69 d were observed in 44 patients,while the body temperature 〉38℃ and neutropenia duration 7.33 ± 4.20 d were observed in 69 patients,the differences between 2 groups was statistically signficant（ P〈0.05）.The EdU test showed that the number of EdU^＋ hematopoietic stem cells and progenitor cells increased.The IL-6 level was different in patients with different peaks of initial bady temperature（ P〈0.05）.The results of amimal experiment showed that the IL-6 could promote the proliferation of hematopoietic stem cells/progenitor cells in vitro and in vivo.Conclusion： For patients with neutropenic infection when initial body temperature peak is 〈38℃,the probability of neutropenia duration prolonging after chamotherapy increases,which may relate with promotive effect of pro-inflammatory cytokins on prliferation of hematopoietic stem cells/progenitor cells.
作者
张潇予
翟卫华
张荣莉
何祎
姜尔烈
伊马秀夫
许元富
冯四洲
韩明哲
ZHANG Xiao- Yu;ZHAI Wei-Hua;ZHANG Rong-Li;HE Yi;JIANG Er-Lie;HIDEO Ema;XU Yuan-Fu;FENG Si-Zhou;HAN Ming-Zhe(Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences ＆ Peking Union Medical College, Tianjin 300020, Chin)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2018年第3期665-670,共6页
Journal of Experimental Hematology
