多参数流式细胞术对急性髓系白血病微小残留病变的监测及对患者复发率的影响

Monitoring of minimal residual lesions in acute myeloid leukemia by multiparameter flow cytometry and its effect on the recurrence rate of patients

目的探究多参数流式细胞术对急性髓系白血病微小残留病变的监测及对患者复发率的影响。方法回顾性分析我院在2015年6月-2017年7月期间采用多参数流式细胞术监测白血病微小残留(MRD)治疗急性髓系白血病患者作为本次的研究对象,观察比较患者治疗前后生活质量水平,并且分析治疗前急性髓系白血病患者的相关免疫的表型(LAIP),同时对治疗后的微小残留病变的水平进行检测。结果治疗后急性髓系白血病患者在认知功能、躯体功能以及角色功能和社会功能等方面的生活质量水平明显优于治疗前(P<0.05);130例初发的急性髓系白血病患者的免疫表型分析,有120例具有明确的LAIP,有18例具有单一的LAIP类型,有112例具有2个或者2个以上的LAIP类型;50例进行诱导化疗并且达到完全缓解且2个疗程的巩固治疗的急性髓系白血病患者的MBD检测结果为,27例检测诱导MRD(Post-IndMRD+)中,有20例患者复发,23例Post-IndMRD-中,有8例复发,Post-IndMRD+和Post-IndMRD-患者的平均无病生存时间差异具有统计学意义(P<0.05),22例巩固治疗后MRD(Post-ConsMRD+全部复发,28例Post-ConsMRD-有6例复发,Post-ConsMRD+和Post-ConsMRD-患者的平均无病生存时间差异具有统计学意义(P<0.05)。结论Post-IndMRD和Post-ConsMRD与患者的平均无病生存时间有关,且多参数流式细胞术监测患者MRD并干预治疗,可以有效的降低急性髓系白血病微小残留病变的复发率。

Objective To investigate the effect of multiparameter flow cytometry on the detection of minimal residual lesions in acute myeloid leukemia (AML) and the recurrence rate. Methods A retrospective analysis was made on the monitoring of minimal residual leukemia(MRD) by multi-parameter flow cytometry in patients with acute myeloid leukemia in our hospital from June 2015 to July 2017. The life quality of patients before and after treatment was observed and compared,and the related immunity of patients with acute myeloid leukemia before and after treatment was analyzed. LAIP and the level of minimal residual lesions after treatment were detected. Results The life quality of patients with acute myeloid leukemia after treatment was significantly better than that before treatment in terms of cognitive function,physical function,role function and social function(P<0.05). 130 cases of acute myeloid leukemia patients with primary immune phenotype analysis,120 cases with clear LAIP,there were 18 cases with single LAIP type,112 cases with 2 or more than 2 types of LAIP;consolidate the treatment of 50 cases of acute myeloid induction chemotherapy and achieved complete remission and 2 courses of the Department of leukemia patients with MBD results,27 cases of Post-Ind MRD+,there were 20 patients with recurrence,23 cases of Post-Ind MRD-,8 cases of recurrence,MRD+ and Post-Ind Post-Ind in patients with MRD- average disease-free survival time difference was statistically significant (P<0.05),22 cases of Post-Cons MRD+ Post-Cons MRD- in 28 cases of recurrence,6 cases of recurrence,Post-Cons The average disease-free survival time of MRD+ and Post-Cons MRD- patients was statistically significant(P<0.05). Conclusion Post-Ind MRD and Post-Cons MRD were associated with the average disease free survival time of patients,and multi parameter flow cytometry can effectively reduce the recurrence rate of minimal residual disease in acute myeloid leukemia.