多参数流式细胞技术动态监测急性髓系白血病微小残留病变的临床价值  

Clinical Value of Multiparametric Flow Cytometry for Dynamic Monitoring of Microscopic Residual Lesions in Acute Myeloid Leukaemia

作　　者：王艺潼 姜佳彤 武风云 刘天月 吴金娜 宋玉国 WANG Yitong;JIANG Jiatong;WU Fengyun;LIU Tianyue;WU Jinna;SONG Yuguo(School of Medical Technology,Beihua University,Jilin 132013,China;Affiliated Hospital of Beihua University,Jilin 132011,China)

机构地区：[1]北华大学医学技术学院,吉林吉林132013 [2]北华大学附属医院,吉林吉林132011

出　　处：《北华大学学报(自然科学版)》2025年第2期196-201,共6页Journal of Beihua University(Natural Science)

基　　金：北华大学研究生创新计划项目(2022019)。

摘　　要：目的应用多参数流式细胞技术,动态监测急性髓系白血病微小残留病变(minimal residual disease,MRD),研究其在患者治疗过程中的临床价值。方法选择有完整临床资料的42例初诊为非M3型急性髓系白血病(AML)患者为研究病例,动态监测治疗过程中MRD表达情况,对不同MRD表达水平与AML患者复发、预后之间的关系进行统计学分析,探索MRD在临床中的应用价值。结果42例初诊为非M3型AML患者经首次诱导缓解治疗后,22例获得FAB形态学完全缓解,CR率为52.38%,且MRD阳性患者CR率明显低于MRD阴性患者(P<0.01)。在1 a治疗周期,24例(57.14%)患者因治疗无效死亡,22例获得过完全缓解的患者中有4例(18.18%)病情复发。单一时间点下,首次诱导缓解治疗后9、12个月MRD表达情况均与AML患者生存、病情复发有关(P<0.05,P<0.01),且MRD阳性表达患者累计死亡率、复发率显著高于阴性表达患者。在持续性监测MRD表达情况的5种分组中,MRD持续阳性组、MRD持续阴性组、MRD阳性转阴性组、MRD阴性转阳性组、MRD阴阳性波动组与AML患者复发率、死亡率、总体生存率(OS)有关(P<0.05),不同MRD表达情况累计死亡率从高到低依次为持续阳性组(100%)、阴性转阳性组(100%)、阴阳性波动组(71.43%)、阳性转阴性组(0)、持续阴性组(0);不同MRD表达情况累计复发率从高到低依次为阴性转阳性组(100%)、持续阴性组(0)、阳性转阴性组(0)、阴阳性波动组(0)。结论动态监测MRD表达情况比单一时间点下MRD表达情况更具有临床应用价值,可有效帮助临床医生相对准确地判断预后,预测AML患者面临的复发风险。Objective To apply multiparametric flow cytometry for dynamic monitoring of minimal residual disease(MRD)in acute myeloid leukaemia and to study its clinical value in treatment of patients.Methods 42 patients initially diagnosed with non-M3 acute myeloid leukaemia(AML)and complete clinical data were selected as study cases.MRD expression was dynamically monitored during the course of treatment,and the relationship between different MRD expression levels and relapse and prognosis in AML patients was statistically analyzed to explore the clinical value of MRD application.Results After the 42 patients initially diagnosed with non-M3 AML were treated with the first induction of remission,22 achieved FAB morphological complete remission,resulting in CR rate of 52.38%.The CR rate was significantly lower in MRD-positive patients than in MRD-negative patients(P<0.01).During the one-year cycle of treatment,24(57.14%)patients died due to treatment failure,and 4(18.18%)of the 22 patients who had achieved complete remission relapsed.At a single time point,MRD expression at 9 and 12 months after the initial induction of remission therapy was associated with survival and disease recurrence in AML patients(P<0.05,P<0.01).The cumulative mortality and recurrence rates were significantly higher in patients with positive MRD expression than in those with negative expression.Among the five subgroups of continuous monitoring of MRD expression-MRD continuous positive group,MRD continuous negative group,MRD positive-to-negative group,MRD negative-to-positive group,and MRD negativeto-positive fluctuating expression group-associations were found with the recurrence rate,mortality rate,and overall survival(OS)of AML patients(P<0.05).The cumulative mortality rates for different MRD expression situations,from high to low,were continuous positive group(100%),negative-to-positive group(100%),negativeto-positive fluctuation group(71.43%),positive-to-negative group(0),and continuous negative group(0).The cumulative recurrence rates for differen

关 键 词：多参数流式细胞技术 急性髓系白血病 微小残留病变 

分 类 号：R733.71[医药卫生—肿瘤]