砷剂治疗急性早幼粒细胞白血病高白细胞期LFA-1,Mac-1和ICAM-1  

Observed LFA-1,Mac-1 and ICAM-1 expression in period of hyperleukocytosis after treatment of As_2O_3 and ATRA

作　　者：张伟华[1] 范星火[1] 张秀莲[1] 陈伟[1] 侯素敏[1] 李殿青[1] 

机构地区：[1]山西医科大学第一医院,山西太原030001

出　　处：《临床医药实践》2003年第11期811-813,共3页Proceeding of Clinical Medicine

摘　　要：目的 :观察三氧化二砷 (As2 O3)和维甲酸 (ATRA)治疗急性早幼粒细胞白血病 (APL )患者高白细胞发生后 ,黏附分子 L FA- 1(淋巴细胞功能相关抗原 - 1)和 Mac- 1以及细胞间黏附分子 - 1(ICAM- 1)的表达。方法 :随机分两组 ,分别选用 0 .1% As2 O310 m L / d,静脉点滴 ;ATRA 2 5 mg· m- 2 · d- 1 ,分 3次口服。分别用流式细胞仪观察两组治疗前及治疗后白细胞增高期外周血白细胞上 L FA - 1和 Mac- 1的表达及其培养上清刺激内皮细胞 ICAM- 1的表达。结果 :As2 O3组和 ATRA组治疗后高白细胞时 L FA - 1分别为 (5 1.87± 17.6 5 ) %和 (4 8.32± 16 .98) % ,Mac- 1分别为 (4 5 .2 5± 19.12 ) %和 (4 3.4 5± 2 0 .6 5 ) % ,明显高于治疗前 ,两组间无明显差别。As2 O3组和 ATRA组高白细胞期 APL骨髓上清刺激内皮细胞表达 ICAM- 1增加分别为 (6 9.39± 18.4 6 ) %和 (6 4 .5 7± 7.2 4 ) % ,明显高于治疗前 (4 2 .35± 9.36 ) %和 (4 5 .5 6± 6 .86 ) %。结论 :As2 O3和 ATRA治疗 APL高白细胞的发生与诱导分化治疗过程中 APL细胞的黏附分子 L FA- 1和 Mac- 1表达增加 ,并刺激内皮细胞 ICAM- 1的增加有关 ,L FA - 1,Mac- 1和ICAM- 1互相作用 ,使 APL细胞与内皮细胞黏附增加 ,并释放入外周血增加。Objective:To evaluated the LFA-1,Mac-1 and ICAM-1 expression on differentiating cells in hyperleukocytosis after treatment of As 2O 3and compared with ATRA.Method:38 patients were divided into two groups and treated with 0.1 % As 2O 310 mL/d,ATRA 25 mg·m -2·d -1,respectively.In hyperleukocytosis after treatment of As 2O 3and ATRA,LFA-1 and Mac-1 expression on differentiating cells were observed,and ICAM-1 expression on human umbilical vein endothelia cells(HUVECs) exposed to the supernatant of bone marrow mononuclear cells of APL in hyperleukocytosis.Result:LFA-1 expression on differentiating cells were(51.87±17.65) % and (48.32±16.98) %,respectively Mac-1 expression on differentiating cells were(45.25±19.12) % and (43.45±20.65) %,respectively,which were increased significantly after treatment with As 2O 3or ATRA.But there were no differentiation between As 2O 3and ATRA groups.ICAM-1 expression on HUVECs exposed to the supernatant of bone marrow mononuclear cells in hyperleukocytosis of APL with As 2O 3and ATRA were(69.39±18.46) % and (64.57±7.24) %,respectively,which were increased significantly after treatment with As 2O 3or ATRA.Conclusion:Hyperleukocytosis in APL with treatment of As 2O 3and ATRA were related with the increased expression of LFA-1 and Mac-1 on differentiating cells,which stimulated HUVECs to express more ICAM-1.LFA-1 and Mac-1 on differentiating cells interacted with ICAM-1 on HUVECs,which increased the adhesion of differentiating cells and HUVECs and resulted to hyperleukocytosis.

关 键 词：砷剂 药物治疗 急性早幼粒细胞白血病 高白细胞期 LFA-1 MAC-1 ICAM-1 细胞间黏附分子-1 三氧化二砷 维甲酸 

分 类 号：R733.71[医药卫生—肿瘤] R977.5[医药卫生—临床医学]