流式细胞仪动态检测成人急性白血病细胞动力学的临床意义

Clinical significance of percentage of S-phase cell analyzed in series by flow cytometry in adult acute leukemia

应用流式细胞仪（ＦＣＭ）动态检测３４例成人急性白血病患者１４６份骨髓标本的细胞动力学参数，并以１０例正常人骨髓标本为对照。结果显示：（１）成人急性白血病患者骨髓标本Ｓ％在不同临床阶段存在一定差异。（２）白血病患者完全缓解时Ｓ％与正常组差异不显著；而巩固强化可使Ｓ％一过性降低。（３）典型病例动态检测表明不同化疗方案对Ｓ％的影响不同。说明动态观察Ｓ％的变化可为诱导和巩固强化的化疗方案个体化提供客观的细胞动力学参数。

Flow cytometric analyses of cellular DNA content in 156 bone marrow specimens were performed in 34 adult patients with ALL(12 cases),AML(22 cases)and 10 normal controls Prior to remission-induction therapy, the percentage of S-phase cells (S%) was 12. 87%±4.84% for patients with ALL versus 21. 32%±2. 72%for control group(P<0.01) and the S% for patients with AML did not differ from that of controls, Prior to consolidation therapy, the S% was identical in the two patient groups (ALL and AML) and control group. The S% for patient with ALL or AML in CR decreased temporarily the day 7 after consolidation therapy. Analyzed in series by FCM in 3 patients(one relapsed and reftactory patinet with AML-M5_a, one AMLM2_a presenting with hyperleukocytosis and one AML-M2_a in CR), cellular DNA content of bone marrow was influenced by chemotherapy regimens. In conclusion the percentage of S-phase cells analyzed in series by FCM in adult acute leukemia might be helpful for selecting individualized regimen for remission-induction therapy and eradication of minimal residual disease.