急性非淋巴细胞性白血病体外长期培养的生长类型与临床关系

Growth patterns of long-term bone marrow culture for acute non-lymphocytic leukemia and their clinical significance

作者应用Ｄｅｘｔｅｒ长期培养体系进行了１７例急性非淋巴细胞性白血病（ＡＮＬＬ）骨髓的长期培养，按照培养４周后基质细胞、ＣＦＵ－ＡＮＬＬ和ＣＦＵ－ＧＭ的生长情况，将其生长状态分为三型．Ⅰ型（１１／１７例）为培养净化有效型；Ⅱ型（３／１７例）为部分净化有效或需经４周以上培养观察其净化效果型；Ⅲ型（３／１７）其基质细胞缺陷，体外培养各种细胞均同步死亡．Ⅰ型患者化疗后有效率（８１．８％）比Ⅱ型（６６．７％）和Ⅲ型（３３．３％）显著地高（Ｐ＜０．０５）．该结果提示临床应用Ｄｅｘｔｅｒ体系净化白血病细胞进行自体骨髓移植时，应按其体外生长类型选择患者，此类型分类与临床状态无关，其净化作用与临床化疗之间无选择性交叉抗肿瘤作用．

Long-term bone marrow culture was conducted on 17 patients with acute non-lymphocytic leukemia(ANLL)employing the Dexter culture system. According to the growth conditions of matrical cells, CFU-ANLL and CFU-GM after 4 weeks of culture,the growth state of the cultured bone marrow was classified into 3 patterns: Pattern Ⅰ(11/17 patients ) was purgatively defined as effective, Pattern Ⅱ (3/17patients)as partially effective and in Pattern Ⅲ the defect of the matrical cells occurred followed by the im- mediate death of all in vitro cultured cells. The patients in Pattern Ⅰ registered a more effective chemothera-peutical result (81.8%)than those in Pattern Ⅱ (66.7%)and Pattern Ⅲ(33.3%) (P<0. 05)did, suggest-ing that during autologous bone marrow transplantation with the Dexter system adopted to purge leukemiccells,the selection of the patients should be based on the in vitro growth pattern of the bone marrow. The present classification showed no association with the clinical state(of the patients ).No selective cross anti-tumor action was observed between this purgation and the clinical chemotherapy.