中高危MDS与MDS/MPN患者骨髓单个核细胞凋亡及临床特征比较

Comparison of apoptosis of bone marrow mononuclear cells and clinical features in patients with advanced MDS and MDS/MPN

目的比较中高危骨髓增生异常综合征（MDS）与骨髓增生异常／骨髓增殖性肿瘤（MDS／MPN）骨髓单个核细胞（BMNCs）凋亡情况及其与患者临床特征的关系。方法收集2013年7月～2015年7月在湖南师范大学附属长沙医院血液科就诊的8例中高危MDS及5例MDS／MPN患者的骨髓标本及临床资料，AO／EB荧光双重染色及Caspase-3活性检测BMNCs凋亡．相关性分析细胞凋亡与患者临床特征的关系。结果凋亡在中高危MDS和MDS／MPN患者BMNCs中的发生率分别为（10．25±1．77）％、（6．90±1．66）％，前者高于后者（P=0．032）；Caspase-3检测显示，中高危MDS患者BMNCs中Caspase-3活性为（0．18±0．04）％，显著高于MDS／MPN组[（0．07±0．02）％]，差异有统计学意义（P=0．028）;相关性分析显示，中高危MDS患者BMNCs凋亡率与骨髓原始细胞比例呈负相关（r=-0．81，P=0．015），而MDS／MPN凋亡率与骨髓原始细胞比例呈正相关（r=0．90，P=0．037）。结论BMNCs凋亡率、Caspase-3活性在中高危MDS和MDS／MPN中明显不同,且BMNCs凋亡和骨髓原始细胞比例相关。

Objective To compare the apoptosis of bone marrow mononuclear cells （BMNCs） in myelodysplastic syndrome （MDS） and myelodysplastic/myeloproliferative neoplasms （MDS/MPN）, and analyze the relationship between apoptosis and clinical characteristics of patients. Methods Bone marrow specimens and clinical data of 8 cases of intermediate/high risk MDS and 5 cases of MDS/MPN patients were collected from July 2013 to July 2015 in Department of Hematology, Changsha Hospital Affiliated to Hu＇nan Normal University. Acridine orange/ethidium bromide fluores- cence staining and Caspase-3 activity assay were used to detect apoptosis of BMNCs, and the correlation between apoptosis and clinical characteristics of patients was analyzed. Results The apoptotic rate in intermediate/high risk MDS and MDS/MPN patients were （10.25±1.77）%, （6.90±1.66）% respectively, the former was higher than the latter （P= 0.032）. Caspase-3 activity assay showed that the Caspase-3 activity of intermediate/high risk MDS BMNCs was （0.18±0.04）%, significantly higher than that of the MDS/MPN group [（0.07±0.02）%], with statistically significant difference （P=0.028）. Correlation analysis showed that negative correlation was found between BMNCs apoptosis and bone marrow blast cell percentage in intermediate/high risk MDS patients （r=-0.81, P=0.015）, but BMNCs apoptotic rate and the proportion of bone marrow blast cells was positively correlated in MDS/MPN patients （r=0.90, P=0.037）. Conclusion The apoptotie rate and Caspase-3 activity are significantly different in intermediate/high risk MDS and MDS/MPN, and there is a correlation between apoptotic rate and bone marrow blasts.