多发性骨髓瘤患者骨髓CD19阳性细胞数值与疗效的相关性

Correlation of CD19 Positive Cell Counts in Bone Marrow with Therapeutic Efficacy in Patients with Multiple Myeloma

本研究分析多发性骨髓瘤(MM)骨髓中CD19(+)细胞与骨髓瘤细胞数目及疗效的关系,探讨MM骨髓CD19(+)细胞变化特点。采用流式细胞术检测63例初诊MM患者骨髓中CD19(+)细胞、CD38(++)CD45(-)细胞、CD38(++)CD45(-)CD56(+)细胞的比值,分析不同分期、不同分型上述细胞比值的差异,以及它们之间的相互关系;分析43例初治时骨髓中CD19(+)细胞、CD38(++)CD45(-)细胞、CD38(++)CD45(-)CD56(+)细胞的比值变化与经过VADM、VD方案治疗4个疗程后疗效的关系。结果表明,63例初治患者骨髓中CD19(+)细胞比值Ⅱ期高于Ⅲ期,CD38(++)CD45(-)CD56(+)细胞比值Ⅲ期高于Ⅱ期;IgA组CD19(+)细胞比值明显高于IgD组且有高于其他组的趋势,IgA组CD38(++)CD45(-)、CD38(++)CD45(-)CD56(+)明显低于其它组;63例初治患者骨髓中CD19(+)细胞与CD38(++)CD45(-)、CD38(++)CD45(-)CD56(+)细胞的比值均呈负相关关系(分别为r=-0.3304,p=0.0052;r=-0.2414,p=0.0441)。分析43例患者(总治疗组)及VD方案治疗组(VD组)中的有效组CD19(+)细胞比值均分别高于无效组,VD组中有效组CD38(++)CD45(-)比值明显低于无效组,CD38(++)CD45(-)CD56(+)有低于无效组的趋势;总治疗组中有效组CD38(++)CD45(-)、CD38(++)CD45(-)CD56(+)均有低于无效组的趋势。结论:MM患者骨髓中CD19阳性细胞的比值与病情、分期有关,对于判断MM预后可能有一定价值。

This study was aimed to analyze the correlation of CD19 positive cell counts in bone marrow of multiple myeloma（MM） patients with therapeutic efficacy and investigate the characteristics of CD19 cell change in MM bone marrow.The CD19（＋） and CD38（＋＋）CD45（-）,CD38（＋＋）CD45（-）CD56（＋） cells in bone marrow of 63 MM patients were detected by flow cytometry.The difference of CD19（＋）,CD38（＋＋）CD45（-）,CD38（＋＋）CD45（-）CD56（＋） cell counts at defferent stages and types,as well as their relation with results of 4 course of VADM or VD chemotherapy were analyzed.The results showed that in 63 MM patients,CD19（＋） cell ratio at stage Ⅱ were higher than those at stage Ⅲ;CD38（＋＋）CD45（-）CD56（＋） cell ratio at stage Ⅱ were lower than those at stage Ⅲ;CD19（＋） cell ratio in type IgA were higher than those in type IgD;the CD38（＋＋）CD45（-）,CD38（＋＋）CD45（-）CD56（＋） cell counts in type IgA were obviously lower than those in type IgG,IgD and light chain which showed a negative correlation between cell counts of CD19（＋） against CD38（＋＋）CD45（-）,CD38（＋＋）CD45（-）CD56（＋）.CD19（＋） cell counts in effective treatment group of all 43 patients and the effective treatment group with VD were both higher than those in the ineffective treatment group;CD38（＋＋）CD45（-）cell counts in effective treatment group with VD was obviously lower than those in ineffective treatment group,and CD38（＋＋）CD45（-）,CD38（＋＋）CD45（-）CD56（＋） in effective treatment group of all 43 patients were lower than those in ineffective treatment group.It is concluded that CD19（＋） cell counts in bone marrow may be related to disease status and development stage of MM,which may be useful to predict treatment efficacy and prognosis.