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目的 建立流式细胞术检测白血病微小残留病 (minimalresiduedisease ,MRD)的方法 ,初步探讨其临床价值。方法 用多种四色荧光抗体组合对患儿初发时的白血病细胞进行检测 ,同时对照多份正常骨髓标本的检测结果 ,以能够使白血病细胞在双参数点图上出现的位置完全不同于正常骨髓细胞的位置的抗体组合作为有效组合 ,以这些有效抗体组合对患者诱导治疗结束后的骨髓标本进行监测。对 5 8例B细胞急性淋巴细胞白血病 (B ALL)患儿初诊时的骨髓标本进行了抗体组合有效性的筛选 ,并对其中的 30例患儿诱导治疗结束后的骨髓细胞进行了监测。结果 有 5 2例 (89.7% )B ALL患儿都可找到适用于MRD检测的抗体组合。四色组合由CD1 0 CD34 CD1 9外加一个有效标志如CD38、CD6 5、CD6 6c、CD2 1 等组成。该方法的敏感度为 0 .0 1% ,远高于形态学检测法。实验中 8例患儿诱导治疗结束后的骨髓细胞形态学检测未见白血病残留细胞 ,但该方法检测结果白血病残留细胞分别为 0 .0 2 8% ,1.4 30 % ,3.0 5 0 % ,0 .0 15 % ,5 .6 6 0 % ,2 .70 0 % ,0 .0 2 7%和 0 .0 6 9%。结论 流式细胞术检测MRD能提高对临床缓解期间患者体内残存白血病细胞数量的评估能力。
Objective To establish a method of flow cytometry for the detection of minimalresiduedisease (MRD) in leukemia and to explore its clinical value. Methods A variety of four-color fluorescent antibody combinations were used to detect leukemic cells in infants with initial onset and to compare the results of multiple normal bone marrow samples to completely differentiate leukemia cells from normal Bone marrow cells as an effective combination of these effective antibody combinations patient induction therapy after the end of the bone marrow samples were monitored. Fifty-eight B-cell acute lymphoblastic leukemia (B ALL) patients were screened for the effectiveness of antibody combinations in bone marrow samples from newly diagnosed patients, and 30 of them were monitored for induction of bone marrow cells after treatment. RESULTS: Fifty-two (89.7%) children with B ALL were able to find antibody combinations suitable for MRD testing. The four-color combination consists of CD10 CD34 CD1 9 plus a valid marker such as CD38, CD6 5, CD6 6c, CD2 1 and so on. The sensitivity of the method was 0.01%, much higher than that of morphological detection. In the experiment, there were no leukemia residual cells in the morphology of bone marrow cells in 8 children after induction therapy. However, the leukemia residual cells in this method were 0.028%, 1.430% and 3.050%, respectively. 0 15%, 5.66 0%, 2.70 0%, 0.027% and 0.06 9%. Conclusion The detection of MRD by flow cytometry can improve the assessment of residual leukemia cells in patients during clinical remission.