CD34^+、CD38^-、CD123^+表型与急性白血病疗效及预后相关性研究

Study on the relationship between immunophenotyping of CD34^+ CD38^-CD123^+ and curative effect and prognosis of the acute leukemia

目的:探讨急性白血病(AL)患者骨髓中CD34^+、CD38^-、CD123^+表型与AL疗效及预后的关系。方法:选取2010年1月至2011年7月经本院收治的初诊AL患者77例,采用三色流式细胞术检测患者免疫表型及细胞群CD34^+细胞的百分比。对各型AL患者给予对症化疗治疗,随访24~40个月,记录患者生存情况。结果:77例患者中,有31例CD123表达阳性,占40.26%;阳性细胞占有核细胞的比例为1%~90.04%,在CD34^+、CD38^-细胞亚群中,CD123^+的平均表达水平为36.17%。化疗2个疗程后,CD123^+表达阳性患者有效率为51.61%,显著低于表达阴性患者的73.91%,差异具有统计学意义(P<0.05)。对患者随访2年,结果发现CD123表达阳性患者1、2年生存率及生存时间均显著低于表达阴性患者,差异具有统计学意义(P<0.05)。结论:CD34^+、CD38~﹣、CD123^+表型能有效反映急性白血病疗效及预后,有望作为白血病干细胞(LSC)公认的特异标志。

objective To discuss the relationship between immunophenotyping of CD34~＋ CD38~﹣CD123~＋ and curative effect and prognosis of the acute leukemia（AL）. Methods 77 patients of AL in our hospital from Jan 2010 to July 2011 were selected.The immunophenotype and the percentage of cells CD34~＋ cells were detected by three color flow cytometry. Each subtype of AL patients were treated by chemotherapy,and 2 years of follow-up, survival rate and survival time were recorded.Results Of 77 patients, there were 31 CD123~＋ case, accounting for 40.26 %;the proportion of positive cells in nucleated cells was1 % ~ 90.04 %;in CD34~＋CD38^-cells, the average expression level of CD123~＋ was 36.17 %.After two course of chemotherapy, the effective rate of CD123~＋ patientswas 51.61 %, significantly less than73.91 % of CD123- patients（P0.05）.After 2 years of followup,The 1, 2 year survival rate and survival time of CD123~＋ patientswere significantly lower than that of CD123^-patients（P0.05）.Conclusion Immunophenotyping of CD34~＋ CD38^-CD123~＋ can effectively reflect the curative effect and prognosis of the acute leukemia,and is expected to be recognized as leukemia stem cells specific marker.