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目的:通过检测B系急性淋巴细胞白血病(B-ALL)患儿外周血(PB)和骨髓(BM)中髓系树突状细胞(mDC)即CD11C+DC和浆细胞样DC(pDC)即CD123+DC的比例,探讨两类DC在儿童B-ALL发病时和缓解后的分布及临床意义。方法:选取B-ALL儿童20例、PB正常对照20例及BM正常对照16例,流式细胞仪检测患儿初诊、治疗第33天PB和BM中CD11C+DC和CD123+DC亚群的比例。观察两类DC在B-ALL患儿治疗前后、BM和PB中的分布情况。结果:B-ALL患儿初诊PB和BM中CD123+、CD11C+比例与正常对照相比明显下降,P<0.001;动态观察同一ALL患儿在治疗后PB和BM中CD123+、CD11C+DC比例明显上升,P<0.01;治疗后PB和BM中CD123+DC比例与正常对照相比略低,仅PB差异有统计学意义,t=2.036,P=0.049;对不同部位样本(BM和PB)的DC比例检测进行比较,发现治疗后PB的CD123+比例较BM低,差异有统计学意义,t=-2.539,P=0.02。结论:B-ALL儿童初诊时体内mDC和pDC水平显著下降,经治疗后明显上调,尤其是mDC亚群;与正常儿童相比,治疗第33天时pDC的水平较低。同时检测BM和PB样本中的DC亚群比单纯PB或BM检测更能反映机体内DC的水平。
Objective: To detect the expression of myeloid dendritic cells (mDCs), CD11C + DC and plasmacytoid DC (pDC) in peripheral blood (PB) and bone marrow (BM) of children with B lineage acute lymphoblastic leukemia CD123 + DC ratio, to explore the distribution of two types of DC in children with B-ALL onset and remission distribution and clinical significance. Methods: 20 cases of B-ALL children, 20 cases of normal PB and 16 cases of normal control were selected. The proportion of CD11C + DC and CD123 + DC subgroups in PB and BM on the 33rd day of treatment was detected by flow cytometry . To observe the distribution of two types of DC in B-ALL children before and after treatment, BM and PB. Results: Compared with the normal controls, the proportion of CD123 + and CD11C + in newly diagnosed PB-B and BM patients was significantly lower than that of the normal controls (P <0.001). The dynamic changes of CD123 + and CD11C + (P <0.01). After treatment, the ratio of CD123 + DC in PB and BM was slightly lower than that in the normal controls, with only PB difference being statistically significant (t = 2.036, P = 0.049) The results showed that the proportion of CD123 + in PB after treatment was lower than that in BM, the difference was statistically significant (t = -2.539, P = 0.02). CONCLUSIONS: The levels of mDC and pDC were significantly decreased in children with B-ALL at initial diagnosis, and were significantly up-regulated after treatment, especially in the mDC subgroup. Compared with normal children, pDC levels were lower on the 33rd day of treatment. Simultaneous detection of DC subpopulations in BM and PB samples was more indicative of DC in vivo than either PB or BM alone.