流式细胞术检测外周血白血病细胞在AL复发的临床价值研究

Research on the application significance of peripheral blood leukemic cells determined by flow cytometry in AL relapse

目的采用多参数流式细胞术(FCM)检测急性白血病(AL)患者外周血白血病细胞的数量,为AL的临床疗效及预后提供参考。方法采用FCM检测71例AL患者外周血标本,同时检测骨髓细胞形态学的变化。结果 FCM检测外周血微小残留病变(MRD)对提示急性髓细胞白血病(AML)复发的敏感性和特异性分别是96.6%和33.3%,对提示急性淋巴细胞白血病(ALL)复发的敏感性和特异性分别是88.9%和44.4%;12例外周血MRD阴性组中有3例(25.0%)患者复发,59例外周血MRD阳性组中有44例(74.6%)复发,MRD阳性组复发率明显高于MRD阴性组(P<0.05);高MRD水平(≥10-2)组和低MRD水平(<10-2)组复发例数分别是37例(97.4%)和10例(47.6%),高MRD水平组复发率明显高于低MRD水平组(P<0.05)。结论 FCM检测外周血白血病细胞对诊断AL复发及指导个体化治疗有重要意义。

Objective To investigate the amounts of peripheral blood leukemic cells from acute leukemia （ AL ） patients determined by flow cytometry （FCM）, in order to provide the reference for clinical efficiency and prognosis . Methods A total of 71 patients with AL were enrolled , and peripheral blood leukemic cells were determined by FCM . The morphological analysis of bone marrow cells was performed .Results The sensitivity and specificity for the diagnosis of acute myeloid leukemia （ AML） relapse by peripheral blood minimal residual disease （ MRD） determined by FCM were 96.6%and 33.3%, and those for the diagnosis of acute lymphocytic leukemia （ALL） relapse were 88.9%and 44.4%.In peripheral blood MRD negative group, there were 3 relapse cases of 12 patients（25.0%）, and in peripheral blood MRD positive group , there were 44 relapse cases of 59 patients （ 74.6%）.The relapse rate of peripheral blood MRD positive group was significantly higher than that of MRD negative group （P〈0.05）.The relapse amounts of high MRD level group （≥10 -2） and low MRD level group （〈10 -2） were 37 cases（97.4%）and 10 cases （47.6%）, and the relapse rate of high MRD level group was significantly higher than that of low MRD level group （P〈0.05）.Conclusions The peripheral blood leukemic cells determined by FCM has significance for the diagnosis of AL relapse and its treatment .