多参数流式细胞术分析415例成人和儿童B-ALL白血病相关免疫表型

Leukemia-Associated Immunophenotypes in 415 Childhood and Adult Patients with B Lineage Acute Lymphoblastic Leukemia by Multiparametric Flow Cytometry Analysis

为了探讨FCM在微量残留病(MRD)检测中的意义,利用4 -6组4色抗体组合,以CD45/SSC设门法对273例成人和142例儿童B系急性淋巴细胞白血病(B-ALL)患者进行了多参数流式细胞术(FCM)免疫分型检测和白血病相关免疫表型(leukemia associated immunophenotyping, LAIP)分析。结果表明:根据CD34和CD10的表达特点,可将B-ALL患者分为I型(CD34+CD10-);Ⅱ型(CD34+CD10+);Ⅲ型(CD34-CD10+);Ⅵ型(CD34-CD10-)。Ⅰ型和Ⅱ型患者LAIP的阳性比例分别为100%和92%,但Ⅲ型患者LAIP阳性率只有79.2%,显著低于Ⅰ型和Ⅱ型患者。总体B-ALL患者LAIP的检出率为90%,成人与儿童组无明显差异。而利用CD34/CD10/CD19/CD45一组抗体,LAIP检出率达到77.6%。结论: 90%成人和儿童B-ALL白血病患者具有LAIP,因此对这类患者适宜用多参数流式细胞术进行MRD监测。

To evaluate the significance of FCM in minimal residual disease（MRD） detection, the immunophenotyping and leukemia-associated immunophenotypes （LAIP）of leukemia cells from 273 adult and 142 childhood patients with B lineage acute lymphoblastic leukemia （B-ALL） were detected by four to six antibody combinations of 4-color CD45/ SSC gating multiparametric flow cytometry （FCM）. The results showed that the B-ALL patients could be classified into 4 subtypes based on different expression CD34 and CD10 ： subtype Ⅰ （CD34^＋/CD10^-）, subtype Ⅱ （CD34^＋/ CD10^＋）, subtype Ⅲ（CD34^-/CD10^＋）, subtype Ⅳ（CD34^-/CD10^-）. The LAIP was observed in 100% and 92% patients of subtype Ⅰ and subtype Ⅱ, respectively, whereas only 79.2% in subtype Ⅲ. The incidence of LAIP in total B-ALL cases was 90% by using the antibodies detected in this investigation. There was no significantce different for incidence of LAIP between adult and pediatric patients. LAIP was observed in 77.6% of patients by labeling only CD34/ CD10/CD19/CD45 4-color antibody combination. It is concluded that in 90% of childhood and adult B-ALL patients LAIP can be found, which suits MRD detection by multiparameter flow cytometry.