急性髓系白血病患者白血病细胞CD34和CD38抗原的表达及其临床意义

Expressions of CD34 and CD38 antigens in leukemia cells of patients with acute myeloid leukemia and their clinical significances

目的:探讨初诊急性髓系白血病(AML)患者白血病细胞CD34和CD38抗原表达与预后的关系,阐明CD34和CD38抗原表达在预测AML患者预后中的作用。方法:收集初诊AML患者94例,采用流式细胞术检测AML患者白血病细胞CD34和CD38抗原的表达,依据CD38抗原表达将患者分为CD34+CD38-组(n=36)和CD34+CD38+组(n=58)。2组患者诱导方案均为IA方案。比较2组患者完全缓解率(CRR)、复发率、中位总生存时间(OS)、中位无病生存时间(DFS)和生存率。结果:CD34+CD38-组患者CRR为77.8%,CD34+CD38+组为86.2%,2组患者诱导治疗后CRR比较差异无统计学意义(P>0.05);CD34+CD38-组患者总复发率和1年内复发率(53.8%和36.0%)均高于CD34+CD38+组(27.9%和14.3%)(P<0.05);CD34+CD38-组患者中位OS(13.60个月)小于CD34+CD38+组(20.33个月)(P<0.05);CD34+CD38-组患者中位DFS(12.87个月)小于CD34+CD38+组(33.93个月)(P<0.05)。CD34+CD38-组患者1年和2年生存率(52.8%和38.9%)低于CD34+CD38+组(75.9%和48.3%)(P<0.05)。结论:白血病细胞CD34+CD38-抗原的表达为初诊AML患者提供一个新的预后指标,表达CD34+CD38-抗原患者预后不良。

Objective To investigate the expressions of CD34 and CD38antigens in the leukemia cells in the patients with firstly-diagnosed acute myeloid leukemia（AML）and their relationships with the prognosis,and to explore the role of the expressions of CD34 and CD38antigens in predicting the prognosis of the AML patients.Methods The expressions of CD34 and CD38antigens in the leukemia cells in 94 cases of AML patients were detected by flow cytometry.36 patients with CD34＋CD38-antigen and 58 patients with CD34＋CD38＋antigen were identified by the expressions of CD38 and treated with IA Regimen.The complete remission rate（CRR）,the relapse rate,the median overall survival（OS）,the median disease free survival（DFS）and the survival rate of the patients in two groups were compared.Results There was no significant difference of the CRR of the patients between CD34＋CD38-and CD34＋CD38＋groups（77.8%vs 86.2%,P〉0.05）.However,the relapse rate and the 1-year relapse rate of the patients with CD34＋CD38-antigen（53.8% and 36.0%）were higher than those of the patients with CD34＋CD38＋antigen（27.0% and 14.3%）（P〈0.05）.The median OS and median DFS of the patients in CD34＋CD38-group（13.60 months and 12.87 months）were shorter than those in CD34＋CD38＋group（20.33 months and 33.93 months）（P〈0.05）.The 1-year and 2-year survival rates of the patients in CD34＋CD38-group（52.8% and 38.9%）were lower than those in CD34＋CD38＋group（75.9% and 48.3%）（P〈0.05）.Conclusion The expression of CD34＋CD38-antigen in the leukemia cells offers a new prognostic factor for the AML patients.The expression of CD34＋CD38-antigen predicts a worse prognosis in the AML patients.