t(8;21)急性髓系白血病患者缓解时ALDH活性对复发的预测意义  

The Predict Significance of ALDH Activity to the Relapse of t(8;21)Acute Myeloid Leukemia Patients at Complete Remission

作　　者：杨璐[1] 刀凤亭 王亚哲[1] 刘艳荣[1] 江浩[1] 江倩[1] 刘开彦[1] 秦亚溱[1] YANG Lu;DAO Feng-Ting;WANG Ya-Zhe;LIU Yan-Rong;JIANG Hao;JIANG Qian;LIU Kai-Yan;QIN Ya-Zhen(Peking University People's Hospital,Peking University Institute of Hematology,National Clinical Research Center for Hematologic Disease,Beijing 100044,China)

机构地区：[1]北京大学人民医院,北京大学血液病研究所,国家血液系统疾病临床医学研究中心,北京100044

出　　处：《中国实验血液学杂志》2021年第1期43-48,共6页Journal of Experimental Hematology

基　　金：国家自然科学基金(81570130,81570128)。

摘　　要：目的:探讨t(8;21)急性髓系白血病(AML)患者治疗前后骨髓乙醛脱氢酶高活性(ALDH^+)细胞比例对复发的预测意义。方法:收集2015年4月至2016年6月北京大学人民医院收治的23例t(8;21)AML患者初诊及完全缓解(CR)时的骨髓标本,采用流式细胞术检测ALDH活性,分析其与复发的关系。结果:全部患者中位随访32(2-52)个月。初诊时CD34^+CD38^-及CD34^+CD38^-ALDH^+细胞中位比例分别为2.7(0.36-35.7)%和0.017(0.0013-0.62)%。CR时CD34^+CD38^-细胞中位比例分别为0.035(0.0064-0.66)%,较初诊时显著下降(P<0.001);CD34^+CD38^-ALDH^+细胞中位比例为0.014(0.0019-0.24)%,与初诊时无明显变化(P=0.45)。生存分析显示,初诊时CD34^+CD38^-及CD34^+CD38^-ALDH^+细胞高比例患者有较低的3年无复发生存(RFS)趋势(P值分别为0.27、0.21)。CR时CD34^+CD38^-及CD34^+CD38^-ALDH^+细胞高比例的患者的3年RFS率显著低于低比例患者(P值分别为0.010、0.0044)。多因素分析显示,CR时CD34^+CD38^-ALDH^+细胞高比例是影响患者RFS的独立预后因素(HR=12.3,95%CI:1.4-107.4,P=0.023)。结论:t(8;21)AML患者CR时骨髓CD34^+CD38^-ALDH^+细胞高比例对复发有预测意义,并且比CD34^+CD38^-细胞比例具有更强的预测复发能力。Objective;To investigate the predict significance of the high aldehyde dehydrogenase activity(ALDH^+)propitiation to the relapse of t(8;21)acute myeloid leukemia(AML)patients before and after treatment.Methods;Bone marrow samples of 23 t(8;21)AML patients diagnosis and achieved complete remission in our hospital from April 2015 to June 2016 were collected,then flow cytometry method was used to detect the activity of ALDH,relationship between it and relapse was analyzed.Results;All the patients were followed up for a median of 32(2-52)months.The median percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells among nucleated cells were 2.7(0.36-35.7)%and 0.017(0.0013-0.62)%at diagnosis,respectively.Among the bone marrow samples in patients achieved CR,the median percentage of CD34^+CD38^-cells was 0.035(0.0064-0.66)%,and it was significantly decreased as compared with the percentage at diagnosis(P<0.001);The median percentage of CD34^+CD38^-ALDH^+cells was 0.014(0.0019-0.24)%,and it showed no different as compared with the percentage at diagnosis(P=0.45).Survival analysis showed that patients with higher percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells at diagnosis tended to the lower 3-year relapse-free survival(RFS)(P=0.27 and 0.21).Furthermore,patients with higher percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells when achieved CR had a significant lower 3-year RFS rates(P=0.010 and 0.0044)as compared with those with lower percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells.Multivariate analysis showed that higher percentage of CD34^+CD38^-ALDH^+cells when achieved CR was an independent factor affecting RFS of the patients.Conclusion;The percentage of CD34^+CD38^-ALDH^+cells at CR in t(8;21)AML patients could predicts relapse,and had more profound predictive significance for relapse than the percentage of CD34^+CD38^-cells.

关 键 词：t(8 21)急性髓系白血病 ALDH 完全缓解 复发 

分 类 号：R733.71[医药卫生—肿瘤]