骨髓增生异常综合征和再生障碍性贫血等骨髓TNF-α活性与白血病的关系  

RELATIONSHIP BETWEEN BM TNF-ALPHA ACTIVITY OF MDS,AA AND LEUKOMEGENESIS

作　　者：冯宝章 张益枝[2] 雷健玲 李瑞 陈克奇[3] 邵宗鸿[2] 郝玉书[2] 

机构地区：[1]天津市费尔生物公司,天津300020 [2]中国医学科学院中国协和医科大学血液病医院,天津300020 [3]中国医学科学院中国协和医科大学血液学研究所,天津300020

出　　处：《白血病》2000年第6期334-337,共4页

摘　　要：目的 :探讨免疫抑制因素 TNF- α在白血病发病中的作用。方法 :在大系列 MDS细胞遗传学研究基础上 ,应用酶联免疫吸附法 (EL ISA)对 2 3例 MDS、17例 AA、10例 AL 和 8例 ITP等患者骨髓液进行 TNF- α活性水平的测定。结果 :MDS TNF- α活性水平有明显增加、AL 则有显著性增加 (P<0 .0 5 )并同它们中染色体核型异常和 SCD阴性检出率的增加相一致。AA与正常人差别不明显 ,ITP与正常人几乎无差别 ,这同它们中大多数患者骨髓细胞核型正常和 SCD阳性的结果相一致。部分病例随访结果显示 ,当 MDS转白血病时不仅其骨髓细胞 SCD由阳性转阴性 ,其 TNF- α活性水平呈数倍于正常值的扩增。结论 :尽管 MDS和 AA同属造血干细胞病并有共同的遗传背景和发病早期 ,但前者主要还与体液免疫抑制因素 (TNF- α)相关 ,而后者则还与细胞免疫抑制因素 (如 T-淋巴细胞 )相关 ,因而有不同的表现。Objective:To study the activity of TNF α in MDS and AA. Methods:There were analysed cytogenetically including karyotypic analysis and SCD assay in a large series of MDS and AA.Among them TNF alpha activity of BM serum were detected by using ELISA in 23 MDS,17 AA,10 AL and 8 ITP.Results:The significant and moderately increased TNF alpha activity were found in AL( P <0.05) and MDS( P =0.1),which were related to their higher percentages of patients with cytogenetic abnormalities,while normal and lower TNF alpha activity were found in ITP( P =0.7) and AA( P =0.4),which were related to their zero and lower percentages of ones.Amplificated activity of TNF alpha in 4 patients,which were followed up for 3～5 months,indicated relationship between amplification of TNF alpha activity and leukomogenesis. Conclusion:The different cellularity of both MDS AA may be due to different immunologic mechanism.The model of development of AL,MDS and AA was proposed,in which the related genes were showed.

关 键 词：MDS AA TNF-α 染色体 白血病 

分 类 号：R556.5[医药卫生—血液循环系统疾病]