ALL患儿诱导缓解治疗中血浆L-Asp活性及抗L-Asp抗体水平变化  

Asparaginase antibody and asparaginase activity in children with ALL during induction therapy

作　　者：江华[1] 顾龙君[1] 薛惠良[1] 陈静[1] 潘慈[1] 陈静1 

机构地区：[1]上海交通大学医学院附属新华医院上海儿童医学中心血液肿瘤科,200127

出　　处：《中国小儿血液与肿瘤杂志》2006年第6期289-292,共4页Journal of China Pediatric Blood and Cancer

基　　金：国家自然科学基金资助项目(30070795)

摘　　要：目的检测35例ALL患儿诱导缓解治疗过程中血浆左旋门冬酰胺酶(L-Asp)活性以及抗L-Asp抗体水平变化,并分析它们之间的相关性。方法通过光度滴定法检测血浆L-Asp活性水平变化;通过ELISA方法检测血浆中抗L-Asp抗体永平变化。结果35例ALL患儿在诱导缓解治疗过程中,L-Asp活性始终保持在较高水平,中位活性为539U/L,无1例酶活性水平在100U/L以下;在L-Asp使用期间及停用后7天时,血浆中抗L-Asp抗体水平无明显变化,只是在停用第十天时抗体水平才有所升高,但与对L-Asp产生过敏患儿的抗体水平相比还有约4倍差距。结论ALL患儿诱导缓解治疗过程中使用L-Asp时血浆中抗L-Asp抗体的产生对L-Asp的作用无显著影响。Objective To estimate the presence of anti - asparaginase antibodies and to correlate the results with L-asparaginase enzymatic activity during the treatment. Methods 35 children with newly diagnosed acutte lymphoblastic leukemia （ALL） were investigated. All patients were treated according to the ALL-XH-99 protocol. L-asparaginase activity was estimated in serum samples, collected before each L-asparaginase administration, using the photometrical method. Anti-asparaginasc antibody concentration was measured by enzyme -linked immunosorbent assay （ELISA） at the four time points： 1 - 2 h before the second dose, the last day of L-asparaginase treatment in the induction, the seventh and tenth day after L-Asp ceased. Results The mean L-asparaginase activity was 539 IU/L in the induction phase; a slight elevated anti-asparaginase antibodies were found in this phase and kept cautiously till the tenth day after L-asp ceased, but it was four- fold lower compared with those with allergic reaction to L-asp. No allergic reactions against L-asparaginase were noted during induction. Conclusion The presence of anti -asparaginase antibodies has no significant effect to L-asparaginase activity during the induction of childhood ALL.

关 键 词：左旋门冬酰胺酶 L-Asp活性 抗L-Asp抗体 急性淋巴细胞性白血病 

分 类 号：R733.71[医药卫生—肿瘤]