老年人急性髓细胞白血病多药耐药蛋白过度表达的实验与临床研究  

Experimental and clinical study on overexpression of multidrug resistance proteins in the elderly acute myeloid leukemia

作　　者：苏丽萍[1] 武玲梅[2] 李乐 张丽[4] 鹿育晋[4] 朱镭[5] 周永安[5] 

机构地区：[1]山西省肿瘤医院血液科,太原030013 [2]山西医科大学第二医院输血科 [3]山西省运城市中心医院风湿免疫科 [4]山西医科大学第二医院血液科 [5]山西省儿童医院中心实验室

出　　处：《白血病．淋巴瘤》2009年第8期464-465,468,共3页Journal of Leukemia & Lymphoma

摘　　要：目的初步分析老年急性髓细胞白血病（AML）患者P-糖蛋白（P—gP）、多药耐药相关蛋白（MRP）、肺耐药蛋白（LRP）的表达及其在预后中的意义。方法流式细胞仪活细胞直接或间接免疫荧光法检测12例初治老年AML（M2a4例，其中1例由MDS转化而来；M4a2例；M5a5例；M61例）患者骨髓白血病细胞P—gP、MRP、LRP表达情况。分析这些多药耐药蛋白表达与预后的关系。结果P—gP、MRP、LRP的表达率分别为58．33％、8．33％、50％；P—gp（＋）、MRP（＋）0，P—gp（＋）、LRP（＋）33．33％，MRP（＋）、LRP（＋）0，P—gp（＋）、MRP（＋）、LRP（＋）8．33％，P-gp（-）、MRP（-）、LRP（-）33．33％，其中P—gP、LRP单独和二者共表达频率较高。P-gp（＋）者的完全缓解（cR）率与2年总生存率（0s）均显著低于P—gp（-）者（P=0．01），LRP（＋）者的CR率与2年0s亦均低于LRP（-）者。结论老年AML患者P—gp、LRP单独及二者共表达频率均较高。P—gp、LRP过度表达是老年AML患者的不良预后因素。Objective To investigate the expression of P-glycoprotein（P-gp）, multidrug resistanceassociated protein （MRP）, lung resistance-related protein （LRP） and predicts treatment outcome in the elderly acute myeloid leukemia. Methods Multi-parameter flow cytometric assay was used to quantify expression of P-gp, muhidrug-associated resistance protein （MRP） and lung resistance-related protein （LRP） in bone marrow viable blasts from 12 eldely acute myeloid leukemia patients at diagnosis （M2a：4, one is come from MDS, M3a：2, M5a：5, M6：1）. Correlation of the MDR protein expression with treatment outcome were analysed. Results The frequency of expression of P-gp, MRP and LRP was 58.33 %, 8.33 %, 50 %, respectively and P-gp（＋）/MRP（＋） 0, P-gp（＋）/LRP（＋） 33.33 %, MRP（＋）/LRP（＋） 0, P-gp（＋）/MRP（＋）/LRP（＋）8.33 %, P-gp（-）/MRP （-）/LRP（-） 33.33 %; respectively. The frequency of overexpression of P-gp or LRP alone and both of them were relatively higher. The rate of complete remission （CR） and overall survival （OS） at one year of P-gp（＋） group were significantly lower than those of P-gp（-） group, and LRP（＋） group also were lower than LRP（-） group. Conclusion The Frequency of expression of P-gp or LRP and coexpression of both of them were higher in elderly patients with AML. The overexpression of P-gp and/or LRP was a poor prognotic factor for eldely myeloid leukemia in elderly patients.

关 键 词：白血病 髓样 急性 老年 P糖蛋白 多药耐药相关蛋白质类 

分 类 号：R733[医药卫生—肿瘤]