红细胞生成素受体在白血病细胞的表达和红细胞生成素水平与白血病贫血关系的探讨  

Expression of Erythropoietin Receptor in Leukemia Cells and Relation of Erythropoietin Level with Leukemic Anemia

作　　者：冯玫[1] 李玉翠[1] 

机构地区：[1]山西省人民医院血液科,山西太原030012

出　　处：《中国实验血液学杂志》2008年第6期1265-1270,共6页Journal of Experimental Hematology

摘　　要：本研究探讨红细胞生成素受体(EPOR)在白血病细胞上的表达及其意义,以及急性白血病患者血清红细胞生成素(sEPO)水平与贫血的关系,为急性白血病(AL)贫血的细胞因子治疗提供新的理论依据。用RT-PCR法检测30例急性白血病患者的白血病细胞EPOR表达,以化学发光法测定sEPO含量,采用全自动血细胞分析仪测定Hb水平。结果表明:30例AL患者中18例表达EPOR,表达率为60%,其中急性髓系白血病(AML)的EPOR表达率为61.9%(13/21),急性淋巴细胞白血病(ALL)的EPOR表达率为55.6%(5/9),AML与ALL的EPOR表达率之间无显著差异(p>0.05),AL的EPOR表达率明显低于对照组(86.7%)(p<0.05)。AML的EPOR表达量高于ALL,AL的EPOR表达量明显低于对照组(p<0.01)。30例AL患者的sEPO水平均明显高于对照组(p<0.01),与Hb水平呈负相关关系(r=-0.658,p<0.01)。结论:急性白血病细胞有EPOR的表达,但表达水平较低,AML与ALL的EPOR表达率无显著差异。AL时EPO对贫血的负反馈机制未受损害,AL贫血不完全是由于机体EPO产生不足所致,推测主要是由于骨髓红系生成受抑制引起。重组人红细胞生成素(rh-EPO)在治疗急性白血病贫血仍被广泛应用,对白血病贫血的病人使用rh-EPO治疗是否可能促进白血病细胞异常增殖尚需进一步分析与研究。This study was purposed to investigate the expression of erythropoietin receptor（EPOR） in leukemic cells and the relationship of serum erythropoietin level with anemia in acute leukemia patients, so as to provide a new theoretical basis for the cytokine therapy in acute leukemia with anemia. The EPOR in 30 AL patients was detected by using reverse transcription polymerase chain reaction （ RT-PCR）, the level of serum erythropoietin was detected by chemiluminescence analysis, the hemoglobin level was assayed by automatic blood counting instrument. The results indicated that EPOR was expressed in 18 out of 30 AL patients, the expression rate of EPOR in AL patients was 60%, however, but the EPOR expression rate in AML was 61.9% （13/21） and 55.6% （5/9） in ALL, the EPOR expression rate was no significant difference between AML and ALL. The EPOR expression rate was significantly lowr than that in control group （86.7%） （p 〈0.05 ）. The relative level of EPOR expression in AML was higher than that in ALL（p 〈 0.05 ）, the average level of EPOR expression in AL was significantly lower than that in control group （p 〈 0.01 ）. The level of sEPO in 30 AL patients was significantly higher than that in control group （p 〈 0.01 ）, and there was negative correlation between the levels of sEPO and Hb （p 〈0.01 ）. It is concluded that the EPOR is expressed in cells of AL, but the expressive level is low. The EPOR expression rate shows no significant difference between AML and ALL. The mechanism of negative feedback to anemia in acute leukemia is intact. Anemia of acute leukemia is not completely associated with inadequate erythropoietin production and relates to hemopoiesis defect that considered as the main reason. Recombinant human erythropoietin is widely used in treatment of anemia caused by acute leukemia. Whether the treatment with rh-EPO for acute leukemia with anemia will enhance the proliferation of leukemia cells, this problem should be explored further.

关 键 词：EPO EPO受体 急性白血病 白血病贫血 

分 类 号：R973.3[医药卫生—药品] R973.6[医药卫生—药学]