原血细胞对于儿童急性B淋巴细胞白血病预后判断的价值  

Prognostic value of bone marrow hematogones in childhood B-lineage acute lymphoblastic leukemia

作　　者：王月芳[1] 江咏梅[1] 高举[2] 周平[1] 张鸽[1] 

机构地区：[1]四川大学华西第二医院检验科,四川成都610041 [2]四川大学华西第二医院儿童血液科,四川成都610041

出　　处：《中国当代儿科杂志》2016年第4期292-296,共5页Chinese Journal of Contemporary Pediatrics

基　　金：四川省科技厅基金项目资助;四川省应用基础研究计划项目(2015JY0044)

摘　　要：目的探讨儿童急性B淋巴细胞白血病(B-ALL)巩固化疗期骨髓原血细胞(HGs)对于儿童急性B淋巴细胞白血病(B-ALL)预后判断的意义。方法回顾性分析196例初发B-ALL患儿,根据危险分型分为高危(n=55)、中危(n=69)和低危(n=72)3组;根据临床结局分为完全缓解(n=165)和复发组(n=31)。采用欧洲BIOMED-1标准化流式细胞术微小残留病(MRD)检测方案,检测巩固化疗期HGs数量。KaplanMeier生存曲线统计患儿无事件生存率(EFS)。结果高危组患儿HGs明显低于中危和低危组,差异均有统计学意义(P<0.05);完全缓解组HGs明显高于复发组,差异有统计学意义(P<0.05);HGs≤1.0%组患儿的EFS明显低于HGs>1.0%组,差异有统计学意义(P<0.05)。结论 HGs可反映B-ALL化疗效果,可用于B-ALL患儿疗效及预后的监测。Objective To study the prognostic value of hematogones（HGs） for childhood B-lineage acute lymphoblastic leukemia（B-ALL） during consolidation chemotherapy. Methods A retrospective analysis was conducted for 196 children with newly-diagnosed B-ALL. They were divided into high-risk group（n=55）, intermediate-risk group（n=69）, and low-risk group（n=72） by risk stratification, and into complete remission group（n=165） and relapse group（n=31） by clinical outcome. The European BIOMED-1 standard flow cytometry for minimal residual disease（MRD） was used to determine the number of HGs during consolidation chemotherapy. The Kaplan-Meier survival curve was used to assess event-free survival（EFS）. Results The high-risk group had a significantly lower number of HGs than the intermediate-risk and low-risk groups（P〈0.05）. The number of HGs in the complete remission group was significantly higher than in the relapse group（P〈0.05）. The children with HGs ≤1.0% had a significantly lower EFS than those with HGs 1.0%（P〈0.05）. Conclusions HGs can be used to assess the treatment outcome and prognosis in children with B-ALL, and proliferation of HGs reflects the good effect of chemotherapy in such children.

关 键 词：急性B淋巴细胞白血病 流式细胞术 原血细胞 微小残留病 儿童 

分 类 号：R733.71[医药卫生—肿瘤]