急性白血病化疗后“凋亡彗星”的检测及临床意义

Determination of apoptotic comet in acute leukemia undergoing chemotherapy and its clinical implication

目的 :观察急性白血病化疗后“凋亡彗星”的变化及其与临床疗效的关系。方法 :采用改良 Singh法 (改良碱性单细胞凝胶电泳 ,即“彗星试验”)检测 15例急性白血病患者化疗后 4、8、12、2 4、36和 72 h“凋亡彗星”的变化。结果 :化疗前“凋亡彗星”均 <0 .5 % ,化疗 8h开始增高 ,2 4h达高峰 ,“凋亡彗星”百分率 >98.0 %、骨髓白血病细胞减少指数 (MBDI) >6 5 .0 %的 11例经 1个疗程化疗完全缓解 ;“凋亡彗星”百分率为 95 .5 %、MBDI为18.5 %的 1例经 2个疗程化疗完全缓解 ;“凋亡彗星”百分率为 84.0 %、MBDI为 6 .1%的 1例经 2个疗程化疗部分缓解 ;“凋亡彗星”百分率为 3.0 %和 5 .5 %、MBDI为 1.1%和 1.6 %的 2例患者临床未缓解。结论 :应用“彗星试验”在急性白血病患者化疗过程中可检出大量早期凋亡细胞 ;“凋亡彗星”的检测是早期判断化疗疗效的良好指标。

Objective:To investigate the variation of apoptotic comet in acute leukemia (AL) undergoing chemotherapy and the ralationship between apoptotic rate and treatment outcomes.Methods:Using improved singh′s method,the apoptotic comet rate was measured in 15 patients with AL after chemotherapy.Result:Before chemotherapy,the apoptotic comet rate were< 0.5 % in all cases. It started to increase at 8 hours and was up to peak at 24 hours after chemotherapy. In 15 patients,11 cases achieved CR after one course and all of their apoptotic comet rate> 98.0 %,MBDI> 65.0 %;Apoptotic comet rate 95.5 %、MBDI 18.5 % was observed in one case that showed CR after two courses;One case achieved PR after two courses and his apoptotic comet rate was 84.0 %,MBDI was 6.1 %;Two cases were unremission that showed apoptotic comet rate 3.0 %、 5.5 %, MBDI 1.1 %、 1.6 % respectively.Conclusion:Using comet assay,a large number of early stage apoptotic cells were detected easily in vivo in patients with AL during induction chemotherapy;Comet assay is a good method in predicting efficacy of chemotherapy.