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目的 :探索急性淋巴细胞白血病 (AL L)患者体外化疗药物诱导白血病细胞凋亡在化疗疗效预测中的价值。方法 :应用 Td T介导的脱氧核苷酸切口和末端标记法 (Tunel)、单克隆抗体免疫组化检测等方法研究 2 8例初治 AL L 患者体外化疗药物诱导白血病细胞凋亡、bcl- 2表达与临床化疗疗效的关系。结果 :2 8例 AL L 患者中 ,2 0例获完全缓解 (CR)者 ,bcl- 2表达显著低于 8例未缓解(NR)者 (P<0 .0 5 ) ;CR患者长春新碱 (VCR)、柔红霉素 (DNR)和地塞米松 (DXM)体外诱导白血病细胞凋亡率均高于 NR患者 ,差异有显著性 (P均 <0 .0 5 ) ;体外 VCR、DNR和 DXM3种药诱导白血病细胞的总凋亡率 ,可以作为临床预测 AL L 患者 VDCP方案疗效的定量指标。结论 :体外化疗药物能否有效地诱导白血病细胞凋亡是判断 AL L 患者化疗敏感性的重要指标
Objective: To investigate the value of chemotherapeutic drug-induced leukemia cell apoptosis in patients with acute lymphoblastic leukemia (AL L) in the prediction of chemotherapy efficacy. Methods: Td T-mediated deoxynucleotidyl transferase nick end labeling (Tunel) and monoclonal antibody immunohistochemistry were used to detect the apoptosis of leukemia cells in 28 newly diagnosed AL patients. The expressions of bcl- 2 expression and the clinical efficacy of chemotherapy. RESULTS: Twenty-two AL patients had 20 cases of complete remission (CR), the expression of bcl-2 was significantly lower than that of 8 cases without NR (P0.05) (VCR), daunorubicin (DNR) and dexamethasone (DXM) in vitro were higher than those in NR patients (P <0.05) DXM3 kinds of drugs can induce the total apoptosis rate of leukemia cells, which can be used as a quantitative index for clinically predicting the efficacy of VDCP regimen in patients with ALL. Conclusion: Whether in vitro chemotherapeutic agents can effectively induce apoptosis of leukemia cells is an important indicator of chemosensitivity in patients with ALL