摘要
目的研究白血病干细胞(LSC)相关抗原CD34、CD38、CD123、CD96和TIM-3在t(8;21)急性髓系白血病(AML)中的表达及预后意义.方法采集2015年10月至2018年4月北京大学人民医院收治的47例初诊t(8;21)AML患者的骨髓标本,采用流式细胞术检测LSC相关膜表面抗原CD34、CD38、CD123、CD96和TIM-3的表达,分析其与复发的关系.结果47例t(8;21)AML患者中,CD34^+CD38^-、CD34^+CD38^-CD123^+、CD34^+CD38^-CD96^+、CD34^+CD38^-TIM-3^+细胞在有核细胞中比例的中位数分别为2.37%、0.24%、0.27%、0.06%;CD34^+CD38^-、CD34^+CD38^-CD123^+、CD34^+CD38^-CD96^+和CD34^+CD38^-TIM-3^+细胞比例与诱导治疗1个疗程缓解率无明显相关性(P值均>0.05);CD34^+CD38^-、CD34^+CD38^-CD123^+和CD34^+CD38^-CD96^+细胞比例高的患者较比例低的患者具有更高的2年累积复发(CIR)率(P值分别为0.049、0.030、0.045),而CD34^+CD38^-TIM-3^+细胞的比例对CIR无明显影响(P>0.05);CD34^+CD38^-细胞比例及微小残留病(MRD)水平是影响患者CIR的独立预后因素(HR=6.9,95%CI 1.3~37.4,P=0.025;HR=11.1,95%CI 1.2~99.2,P=0.031).结论不同的LSC相关抗原在t(8;21)AML中的预后意义不同,初诊骨髓有核细胞中高比例的CD34^+CD38^-以及CD34^+CD38^-CD123^+和CD34^+CD38^-CD96^+细胞可能与t(8;21)AML患者的复发有关.
Objective To investigate the characteristic and prognostic significance of leukemia stem cells associated antigens expressions including CD34,CD38,CD123,CD96 and TIM-3 in t(8;21)AML.Methods Bone marrow samples of 47 t(8;21)AML patients were collected at diagnosis from October 2015 to April 2018 in Peking University Peoples'Hospital,then flow cytometry method was performed to detect the expression frequencies of CD34,CD38,CD123,CD96 and TIM-3 to analyze the relationship between leukemia stem cells associated antigens expressions and relapse.Results Of 47 t(8;21)AML patients tested,the median percentages of CD34^+CD38^-,CD34^+CD38^-CD123^+,CD34^+CD38^-CD96^+and CD34^+CD38^-TIM-3^+cells among nucleated cells were 2.37%,0.24%,0.27%and 0.06%,respectively.All the frequencies of CD34^+CD38^-,CD34^+CD38^-CD123^+,CD34^+CD38^-CD96^+and CD34^+CD38^-TIM-3^+cells had no impact on the achievement of CR after the first course of induction.All higher frequencies of CD34^+CD38^-,CD34^+CD38^-CD 123+,CD34^+CD38^-CD96^+cells were related to higher 2-year CIR rate.Whereas,the frequency of CD34^+CD38^-TIM-3^+cells had no impact on CIR rate.Both high frequency of CD34^+CD38^-cells and the high level of minimal residual diseases(patients with<3-log reduction in the RUNX1-RUNX1T1 transcript level after the second consolidation therapy)were independent poor prognostic factors of CIR[P=0.025,HR=6.9(95%CI 1.3-37.4);P=0.031,HR=11.1(95%CI 1.2-99.2)].Conclusion Different leukemia stem cells associated antigens had distinct prognostic significance in t(8;21)AML.High frequencies of CD34^+CD38^-,CD34^+CD38^-CD123^+and CD34^+CD38^-CD96^+cells at diagnosis predicted relapse in patients with t(8;21)AML.
作者
刀凤亭
杨璐
王亚哲
常艳
江倩
江浩
刘艳荣
黄晓军
秦亚溱
Dao Fengting;Yang Lu;Wang Yazhe;Chang Yan;Jiang Qian;Jiang Hao;Liu Yanrong;Huang Xiaojun;Qin Yazhen(Peking University Peoples’Hospital,Peking University Institute of Hematology,National Clinical Research Center for Hematologic Disease,Beijing 100044,China)
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2019年第10期831-836,共6页
Chinese Journal of Hematology
基金
国家自然科学基金(81570130、81870125)。
