急性白血病患者血清sFas、TNFα水平及其与治疗效果的关系

SERUM CONCENTRATION OF SOLUBLE FAS AND TUMOR NECROSIS FACTOR-α AND THEIR CLINICAL CORRELATION WITH CHEMOTHERAPY OUTCOME IN PATIENTS WITH ACUTE LEUKEMIA

目的 :了解急性白血病 (AL)患者血清 s Fas和 TNFα水平及意义。方法 :EL ISA法测定 30例 AL 患者血清 s Fas,放免法测定 32例 AL 患者 TNFα含量 ,并与正常对照比较 ,分析二者与化疗效果的关系。结果 :难治复发者的 s Fas在 AL L 为 (7.14± 2 .18) μg/L,ANL L 为 (9.6 9± 3.5 1) μg/L,均明显高于对照 (3.49± 2 .36 ) μg/L,也明显高于其相应的 CR组 ,AL L 的 CR患者 (3.72± 0 .72 ) μg/L,ANL L 的 CR患者 (4 .2 3± 1.98) μg/L。s Fas比对照高出 2倍的患者化疗获得 CR的机会明显下降。初发未治时血清 TNFα为 (6 .0 7± 1.32 ) pmol/L,化疗后非 CR者为(5 .79± 1.2 7) pmol/L,复发者为 (7.5 0± 1.6 7) pmol/L,均明显高于对照 (2 .32± 0 .90 ) pmol/L和化疗后 CR者(4 .14± 1.5 ) pmol/L。TNFα水平与骨髓原始细胞数有关 ,并受感染影响而增高。结论 :血清 s Fas、TNFα在 AL 患者均明显升高 ,是预后不良的因素。

Objective:To determine the serum concentration of soluble Fas(sFas) and tumor necrosis factor-α(TNFα)and to evaluate their clinical correlation with chemotherapy outcome in patients with acute leukemia.Methods:Enzyme linked immunosorbent assay was used to measure sFas,radioimmunoassay was used to measure TNFα.Results:Serum sFas concentration was(7.14±2.18)μg/L(9.69±3.51)μg/L in refractory/relapsed acute lymphocytic and non-lymphocytic leukemia patients respectively,both were significantly higher than that in the control (3.49±2.36 μg/L),also significantly higher than that in its corresponding complete remission patients.Patients with higher sFas concentration showed low complete chemotherapy remission rate. Patients with acute leukemia had a singificantly increased level of TNFα (6.07±1.32 pmol/L)before treatment, as compared with that in complete remission (4.14±1.5 pmol/L),in non-complete remission(5.79±1.27 pmol/L) and in relapsed patients(7.50±1.67 pmol/L),while the control was (2.32±0.90)pmol/L.The level of TNFα was positively related to the number of blast cells in bone marrow.Infection had influence on the TNFα level.Conclusion :Acute leukemia patients had higher level of sFas and TNFα.Increased serum level of sFas and TNFα may be related with poor prognosis.Measurement of sFas and TNFα may be helpful to evaluate chemotherapy result.