细胞凋亡在慢性髓性白血病加速、急变期中的意义

Significance of Apoptosis during the Progression of Chronic Myeloid Leukemia

目的:探讨细胞凋亡在慢性髓性白血病(chronicmyeloidleukemia,CML)加速、急变中的意义。方法:CML不同临床分期的41例患者,分离骨髓单个核细胞(bonemarrowmononeuclearcells,BMMNC),用DNA凝胶电泳、流式细胞仪及原位末端标记法检测细胞凋亡,荧光分光光度法检测caspase3活性,流式细胞仪测定细胞周期分布。结果:CML各组用DNA凝胶电泳法均未见梯状条带;流式细胞仪及原位末端标记法检测细胞凋亡,发现CML各组间未见显著差异;急变期组caspase3活性明显低于慢性期未治疗组及治疗组;急变期组较慢性期组G0/G1期细胞显著增多,S期细胞显著减少。随访19例慢性加速期组患者,发现5例1年内发生急变,未急变者与急变者caspase3活性分别为86.91±23.42及69.85±15.37,P>0.05。结论:细胞凋亡受抑可能在CML急变形成过程中发挥一定的作用。

Objective:To explore the significance of apoptosis during the progression of chronic myeloid leukemia(CML).Methods:BMMNC were separated from41CML patients of dif-ferent clinical phases.Apoptosis was detected by DNA gel electrophoresis,cytometry and in situ end labeling.Caspase3activity and cell cycle were detected by fluorometry and flow cytom etry respectively.Results:No DNA ladder was found in BMMNC of all the patients.No siog nifi cant difference of apoptosis was found between the BMMNC from patients of different clinical phasesby either cytometry or in situ end labeling.The caspase3activity was decreasedduring the progres-sion of CML.Compared with CP patients,the cell cycles of BMMNC of BC ones were character-ized by significantly higher G0/G1and lower S cell fraction.Follow-up was carried out in15CP and4AP patients for one year,BC was taken place in2CP and3AP ones.The caspase3ac-tivity of patients undergoing BC versus no BC were69.85±15.37vs86.91±23.42(P>0.05).Con-clu sion:The inhibition of apoptosis may play a role in the blastic transition of CML.