儿童急性淋巴细胞白血病化疗后T淋巴细胞重建的研究

Study of the T lymphocytes recovery in children with acute lymphoblastic leukemia after cessation of chemotherapy

目的观察急性淋巴细胞白血病儿童在化疗结束后T淋巴细胞亚群的变化，了解T淋巴细胞重建过程。方法采用流式细胞仪分析76名ALL治疗后停药不同阶段的儿童外周血T淋巴细胞亚群。结果CD3^＋HLA—DR^＋细胞、CD4^＋CD45RO^-CD45RA^-细胞百分率在停药后0～12月组高于对照组（P〈0．05），CD3^＋CD4^-CD8^＋、CD8^＋CD28^-细胞百分率在停药后0～12月、12～24月24～48月组均高于对照组，CD3^＋CD8^-CD4^＋、CD4^＋CD45RO^-CD45RA^＋细胞的百分率、CD4／CD8值、CD45RA／CD45RO值在停药各个阶段与对照组相比明显降低（P〈0．05）。结论化疗结束后，活化的T细胞可能在停药早期免疫系统的监视作用中起积极的作用，患儿的T淋巴细胞恢复需要较长的时间。CD4^＋CD45RO^-CD45RA^＋、CD3^＋CD4^＋CD8^-淋巴细胞的恢复最慢。

Objective We examine the change of T lymphocytes after cessation of chemotherapy to clarify the reconstituion of the T lymphocytes in children with ALL. Methods T lymphocytes subsets of 76 children with ALL in different stage of cessation chemotherapy were analyzed by flow cytometry to observe the recovery of T lymphocytes. Results The percent of CD3^＋ HLA - DR^＋,CD4^＋CD45RO^- CD45RA^- are significant higher in the 0 - 12 months after cessation of chemotherapy group than that of control group （P 〈0. 05）. The percent of CD3^＋CD4^- CD8^＋ , CD8^＋ CD28^- are higher in 0 - 12 months, 12 -24 months, 24 -48 months after cessation of chemotherapy group than control group （ P 〈 0. 05 ）. The percent of CD3^＋CD4^＋CD8^- , CD4^＋CD45RO^-CD45RA^＋ and CD4/CD8, CD45RA/CD45RO are significant lower in all group than that of control group during observing time （P 〈 0. 05）. Conclusion These finding demonstrate that there are high DR^＋T cells in the 0 - 12months after cessation group, suggesting that activated T cells may play a role in the immune surveillance system after chemotherapy. The recovery of T lymphocytes repuires long time, the slowest recovery is CD3^＋CD4^- CD8^＋ CD4^＋, CD45RO^- CD45RA^＋ cell.