流式细胞术动态监测微小残留病在急性髓系白血病治疗中的临床意义  

Clinical significance of dynamic monitoring of minimal residual disease by flow cytometry in the treatment of acute myeloid leukemia

作　　者：陈晓红 吴广胜[2] 农卫霞[2] 潘歆[2] 王燕[2] 张红霞[2] 章大谦[2] 龙珍珠玛[2] CHEN Xiao-hong;WU Guang-Sheng;NONG Wei-xia(Medical college of Shihezi University,Shihezi 832000,China;Department of Hematology,the First Affiliated Hospital of Shihezi University Medical college,Shihezi 832000,China)

机构地区：[1]新疆石河子大学医学院,新疆石河子832000 [2]新疆石河子大学医学院第一附属医院血液科,新疆石河子832000

出　　处：《吉林医学》2021年第3期561-564,共4页Jilin Medical Journal

摘　　要：目的:探讨流式细胞术动态监测微小残留病对于预测急性髓系白血病复发、指导治疗及判断预后等临床意义。方法:收集40例非M3-AML为研究对象,评价首次化疗后不同MRD水平患者的完全缓解情况并评价其与预后分层的关系。其中27例完全缓解患者作为另一组研究对象,依据MRD水平分组,评价1年复发率及无病生存情况。结果:首次化疗后不同MRD水平患者缓解情况比较,差异无统计学意义(P>0.05);分子学预后良好组具有更高的MRD阴性率,差异有统计学意义(P<0.05);CR患者四组的1年复发率分别为88.89%、27.27%、66.67%、25.00%,提示MRD持续阳性组具有更高的复发率,差异有统计学意义(P<0.05);生存分析提示持续阴性组的生存率与持续阴性组相比,差异无统计学意义(P>0.05)。结论:流式细胞术动态监测MRD对指导AML治疗、早期预测复发及评估预后具有重要的临床意义。Objective To investigate the clinical significance of dynamic monitoring of minimal residual disease by flow cytometry in predicting the recurrence of acute myeloid leukemia,guiding treatment and judging prognosis.Method The 40 non-M3-AML were collected to evaluate the complete remission of patients with different MRD levels after the first chemotherapy and to evaluate their relationship with prognostic stratification.Among them,27 patients with complete remission as another group of subjects,according to the MRD level grouping,to evaluate the 1 year recurrence rate and disease-free survival.Results There were no difference between different MRD levels after the first chemotherapy(P>0.05);A good group with advanced molecular MRD negative rate(P<0.05);The CR patients were divided four groups,and their 1year recurrence rate were 88.89%、27.27%、66.67%、25.00%,respectively;It pointed out the MRD persistent positive group had higher recurrence rate(P<0.05).Survival analysis showed that there was no difference between the survival rate of the persistent positive group and the persistent negative group(P>0.05).Conclusion The dynamic monitoring MRD of flow cytometry has important clinical significance in guiding AML treatment,early prediction of recurrence and evaluation of prognosis.

关 键 词：急性髓系白血病 微小残留病 完全缓解 复发 预后 

分 类 号：R733.71[医药卫生—肿瘤]