多参数流式细胞术识别与急性髓系白血病微小残留病具有类似表型的再生细胞  

Multi-parameter flow cytometry identifies regenerating cells with phenotypes similar to minimal residual disease in acute myeloid leukemia

作　　者：范桥珍 康蕊 张婷 Fan Qiaozhen;Kang Rui;Zhang Ting(Department of Special Testing Laboratory,Beijing Qinghe Hospital,Beijing 100192,China)

机构地区：[1]北京清河医院特检实验室,北京100192 [2]北京高博医院流式研究院

出　　处：《临床荟萃》2024年第8期716-727,共12页Clinical Focus

摘　　要：目的探讨如何利用多参数流式细胞术(MFC)鉴别与急性髓系白血病(AML)微小残留病(MRD)具有类似表型的正常细胞。方法回顾性分析2020年3月-2022年4月在我院利用MFC检测的AML患者MRD骨髓标本157例次,识别容易被误认为是MRD的正常细胞。结果AML患者治疗后再生的骨髓样本中会出现如下易误判为MRD的正常细胞群:CD117 dim CD56^(+)CD7^(+)CD45^(str)自然杀伤(NK)细胞、CD19 dim CD56^(+)CD7^(+)CD45^(str) NK细胞、CD300e^(+)HLA-DR^(+)CD14^(part) CD64^(part)非经典单核细胞;这些细胞群占骨髓有核细胞比例的中位值分别是0.084%(范围:0~0.6200%)、0%(范围:0~0.2134%)、0.1549%(范围:0~2.0940%)。结论MFC检测AML患者MRD过程中,应避免将治疗后骨髓再生的正常细胞,误判为残留病。Objective To discriminate normal cells with similar phenotypes to minimal residual disease(MRD)in acute myeloid leukemia(AML)by multi-parameter flow cytometry(MFC).Methods A total of 157 consecutive bone marrow aspirates for routine MRD between March 2020 to April 2022 were retrospectively analyzed.Normal cells misrecognized as MRD were identified.Results The following normal cell populations were easily misrecognized as MRD in regenerated bone marrow samples of AML patients after treatment:CD117 dim CD56^(+)CD7^(+)CD45^(str) natural killer(NK)cells,CD19 dim CD56^(+)CD7^(+)CD45^(str) natural killer(NK)cells,and CD300e^(+)HLA-DR^(+)CD14^(part) CD64^(part) non-classical monocytes.The median proportion of these cell populations in the bone marrow nucleated cells was 0.084%(range,0-0.6200%),0%(range,0-0.2134%),and 0.1549%(range,0-2.0940%),respectively.Conclusion It is necessary to avoid a misdiagnosis of normal cells regenerated by bone marrow as MRD by MFC in AML patients after treatment.

关 键 词：急性白血病 多参数流式细胞术 微小残留病 正常细胞 再生 

分 类 号：R733.7[医药卫生—肿瘤]