急性早幼粒细胞白血病患者血清及NB4细胞上清对正常粒系造血功能的影响  

The effects of sera of acute promyelocytic leukemia patients and culture supernates of NB4 cells on normal granulo macrophage hematopoiesis

作　　者：周荣富[1] 孙关林[1] 吴文[1] 邬维礼[1] 王振义[1] 

机构地区：[1]上海第二医科大学附属瑞金医院,上海血液学研究所,200025

出　　处：《中华血液学杂志》1999年第7期343-346,共4页Chinese Journal of Hematology

摘　　要：目的　探讨急性早幼粒细胞白血病 (APL)患者血清对正常粒 单核系祖细胞 (CFU GM )生长的影响及其抑制活性变化的有关因素。方法　用细胞培养方法动态观察了 2 4例APL患者在全反式维甲酸 (ATRA)治疗过程中 ,其血清对正常CFU GM生长的影响 ;用ELISA和生物活性法分别检测血清中粒细胞集落刺激因子 (G CSF)、γ干扰素 (IFN γ)及肿瘤坏死因子 (TNF)活性。结果　治疗前 ,血清对CFU GM的生长呈抑制作用 ,抑制活性明显高于骨髓缓解时和正常血清 (P <0 0 1) ;治疗过程中 ,血清对CFU GM的抑制活性逐渐加强 ,在白细胞达高峰前 3～ 6天最强 ,然后逐渐减弱 ;骨髓缓解时 ,血清对CFU GM的抑制活性明显下降 ,与正常血清比较 ,差异无统计学意义。血清对正常CFU GM抑制活性与患者骨髓白血病祖细胞 (CFU L)、早幼粒细胞百分率呈正相关 ,与骨髓CFU GM呈负相关 ,与血清G CSF含量或TNF活性间无线性相关。血清IFN γ活性为阴性。结论　①未治疗的APL患者血清对正常粒 单核系造血有抑制作用。ATRA治疗APL取得缓解的机制之一 ,是通过诱导白血病细胞分化成熟 ,造血抑制活性不断减低 ,正常造血得以恢复 ;②血清抑制活性的异质性除与白血病细胞有关外 。Objective To explore the inhibitory activity of sera from acute promyelocytic leukemia(APL) patients on the growth of granular macrophage progenitors(CFU GM) and factors affecting the inhibitory activity Methods Sera of 24 APL patients on the all trans retinoic acid(ATRA) therapy course were kinetically obtained for cellular culture assay Meanwhile,granulocyte colony stimulating factor(G CSF),interferon γ and tumor necrosis factor(TNF) activities in the patient serum and supernate of NB4 cell culture were detected Results Before treatment, there was an inhibitory activity on CFU GM growth in the sera of APL patients and it was statistically higher than that in remission patients and controls(P< 0 01) As the treatment going on the activity was gradually increased,reached its maximum 3～6 days prior to the peak of white blood cell(WBC) and declined to normal when bone marrow remission was obtained It was positively correlated with the number of CFU L and the percentage of promyelocyte in bone marrow,negatively with the number of CFU GM but not with serum G CSF and TNF activity Serum G CSF level was positively correlated with the number of WBC(P< 0 05).No serum IFN γactivity was detected in the sera Conclusions ①One of the therapeutic mechanisms of ATRA on APL is that ATRA induces APL cell maturation thus reduces the serum inhibitory activity on normal hematopiesis ②The inhibitory activity of APL patient serum on normal hemopoiesis consists of complicated factors

关 键 词：白血病 APL 维甲酸 肿瘤坏死因子 药物疗法 

分 类 号：R733.710.5[医药卫生—肿瘤]