流式细胞术检测急性白血病微小残留病变的应用

Detection of minimal residual disease in acute leukemia by flow cytometry

目的探讨流式细胞术在急性白血病微量残留检测中的应用价值。方法基于初诊急性白血病相关的免疫表型,采用四色流式细胞术、CD45/SSC和CD45/CD19双参数散点图设门,以初发异常的抗体组合检测81例106份完全缓解后急性白血病的微量残留病细胞。结果 81例初发急性白血病检测出19种白血病相关的免疫表型,66%患者存在初发抗体表达量的异常。用初发异常抗体组合发现13例存在白血病细胞,为微量残留白血病阳性,8例发生免疫表型变化,占62%。结论根据初诊急性白血病相关的免疫表型,流式细胞术对骨髓中各系造血前体细胞的定性定量检测可用于急性白血病微小残留病变的确诊和早期诊断复发。

Objective To evaluate the application value of flow cytometry （FCM ） in screening minimal re-sidual disease （MRD）in acute leukemia（AL） .Methods On the basis the of leukemia-associated immunopheno-types （LAIPs） of 81 with AL ,using incipient abnormal antibodies the MRD of 106 consecutive bone marrow speci-mens from 81 patients who achieved complete remission were detected by 4-color antibody combination ,CD45/SSC and CD45/CD19 gating FCM .Results Ninteen LAIPs were detected in 81 cases with AL .Abnormal expression of incipient antibodies was detected in 81 patients .Thirteen patients were MRD positive and had residual leukemia cells .Eight patients had the modulation of LAIPs.Conclusion According to the LAIPs of AL ,multi-parameter FCM using 4-color antibody panel is appropriate to detect MRD.