急性淋巴细胞白血病患儿复发及治疗失败时白血病相关免疫表型的改变  

Investigation of Leukemia-Associated Immunophenotyping at Relapse and Treatment Failure in Children with Acute Lymphoblastic Leukemia

作　　者：程翼飞[1] 张乐萍[1] 陆爱东[1] 刘艳荣[2] 刘桂兰[1] 

机构地区：[1]北京大学人民医院儿科,北京100044 [2]北京大学人民医院血液病研究所,北京100044

出　　处：《实用儿科临床杂志》2009年第15期1155-1157,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的对比ALL患儿复发及治疗失败时免疫表型的改变以及微小残留病(MRD)免疫表型与复发时免疫表型的改变。方法2000年8月-2007年12月共收治ALL患儿复发及治疗失败病例33例。复发患儿在复发前采用流式细胞术检测MRD,治疗失败患儿在诱导化疗结束后检测MRD。将复发时与治疗失败时的免疫表型与初治免疫表型进行对比;将患儿复发前MRD免疫表型与初治免疫表型进行对比,分析表面抗原表达改变的规律。结果1.B-ALL患儿27例中23例(85.18%)复发时与初治时比较,至少有1个表面抗原荧光强度改变。相对于初治免疫表型,其中6例CD45表达减弱,2例增强;CD19表达减弱2例,增强1例;CD34表达减弱6例,增强4例。CD10表达减弱5例,增强7例。2.复发/治疗失败T-ALL患儿6例均检测了CD45,相对于初治免疫表型荧光强度无变化。3.共有15例ALL患儿在复发前至少出现过1次MRD。相对于复发时的免疫表型,25次MRD中1次CD45表达增强;CD19表达减弱1次;CD34表达减弱2次,增强8次;CD10表达减弱6例,增强3例。结论ALL患儿的免疫表型在治疗失败/复发时可能发生改变,且B-ALL的改变率高于T-ALL,但改变不影响MRD的检测。Objective To investigate the stability of immunophenotyping in the course of relapse or at treatment failure of patients with acute lymphoblastic leukemia（ALL） and that of immunophenotyping of positive minimal residual disease（MRD）. Methods From Aug. 2000 to Dec. 2007,33 children with ALL who relapsed or treated failure were enrolled. These children were detected MRD by flow cytometry. The immunophenotyping of children who relapsed or treated failure were compared with that of initial therapy;the immunophenotyping of MRD relapsed was compared with that of initial therapy. Results 1. In 23 out of 27 cases （85.18%） with B - ALL, changed at least 1 antigen between diagnosis and relapse. Six children with CD45 down - modulation and 2 children with CD45 up - modulation. Two children with CD19 down - modulation and 1 child with CD19 up - modulation. Six children with CD54 down - modulation and 4 children with CD34 up - modulation. Five children with CD10 down - modulation and 7 children with CD10 up - modulation. 2. Six children with T - ALL had the same expression in CD,5 between relapse and treatment failure. 3. These were 15 children had the least 1 case MRD,25 cases MRD were detected, these was 1 case up - modulation in CD45,1 case down - modulation in CD19,2 cases up - modulation and 8 cases down - modulation in CD34 ,3 cases up - modulation and 6 cases down - modulation in CD10. Conclusions Immunophenotyping of children with ALL may change at relapse and treat- ment failure. The frequency of change in B - ALL is higher than that of in T - ALL, but the change can not impact the detection of MRD.

关 键 词：免疫表型 复发 淋巴细胞白血病 急性 儿童 

分 类 号：R733.7[医药卫生—肿瘤]