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目的:探索缓解与未缓解急性髓系白血病干细胞表面抗原表达差异,为判定化疗疗效及其预后提供依据。方法:按照急性白血病诊断标准,根据患者入院时骨髓白血病细胞数量多少分成临床缓解与未缓解两组,以流式细胞仪分别检测骨髓中白血病干细胞表面相关抗原表达情况,比较二者之间差异。其中经标准化疗方案治疗结束后,通过复查骨髓象判定疗效并比较化疗前后白血病干细胞表面相关抗原表达变化。结果:与缓解的急性髓系白血病患者骨髓白血病干细胞相关抗原表达值相比,未缓解的患者骨髓白血病干细胞表面相关抗原表达明显升高,差异具有统计学意义(P<0.05,0.001);未缓解的患者经标准方案化疗后骨髓虽然已经获得完全缓解,但依然具有白血病干细胞表面抗原高表达,提示这部分患者依然有复发的可能性。结论:急性髓系白血病患者的白血病干细胞相关抗原表达值升高是急性白血病复发难治的根源之一。
OBJECTIVE: To explore the differences of the expression of surface antigens in acute myeloid leukemia stem cells with or without remission, and to provide evidence for the evaluation of the efficacy and prognosis of chemotherapy. Methods: According to the diagnostic criteria of acute leukemia, the number of myeloid leukemia cells on admission was divided into clinical remission and non-remission. The expression of antigens on the surface of leukemia stem cells in bone marrow were detected by flow cytometry, and the difference was compared. After the standard chemotherapy regimen was over, the curative effect was evaluated by reviewing the bone marrow and the changes of the surface antigen expression on leukemia stem cells before and after chemotherapy were compared. Results: Compared with the expression of myeloid leukemia stem cell-associated antigen in patients with acute myeloid leukemia, the expression of surface antigen associated with myeloid leukemia stem cells in patients with unrelated acute myeloid leukemia was significantly increased (P <0.05, 0.001) Of patients after standard chemotherapy, although the bone marrow has been completely relieved, but still has high expression of leukemic stem cell surface antigen, suggesting that some patients still have the possibility of recurrence. Conclusion: The increase of leukemic stem cell associated antigen expression in patients with acute myeloid leukemia is one of the causes of refractory acute leukemia relapse.