CD44^(+)单个核细胞及脾脏硬度在急性髓系白血病微小残留病及预后中的价值

The Value of CD44 Mononuclear Cells and Spleen Stiffness Measurement in Minimal Residual Disease in Acute Myeloid Leukemia and Its Prognosis

目的:探讨CD44^(+)单个核细胞(MNC)比例及脾脏硬度(SSM)在急性髓系白血病(AML)微小残留病(MRD)及预后中的价值。方法:用流式细胞仪检测44例AML患者诱导化疗后14 d,外周血CD44^(+)MNC和CD24^(+)MNC的比例,以瞬时弹性成像技术检测SSM,并探讨MNC及SSM在MRD和预后中的价值。结果:MRD^(+)组CD44^(+)MNC%、SSM显著高于MRD-组(P<0.05);MRD^(+)组中,MRD水平、SSM与CD44^(+)MNC正相关(r=0.998,r=0.939,P<0.05);HCD44^(+)MNC组中位EFS及OS显著短于LCD44^(+)MNC组(P<0.05);HSSM组EFS及OS显著短于LSSM组(P<0.05)。CD24^(+)MNC与MRD及预后不相关。结论:HCD44^(+)MNC及HSSM可预测高水平MRD,预后差,或可用来评估患者预后。

Objective:To investigate the value of CD44^(+) mononuclear cells(MNC) and spleen stiffness measurement(SSM) in minimal residual disease(MRD) in acute myeloid leukemia(AML) and its prognosis.Methods:Flow cytometry was used to detected the proportion of CD44^(+) and CD24^(+) MNC in 44 AML patients after induction chemotherapy.The SSM was tested by FS.The value of MNC and SSM in MRD and its prognosis was explored.Results:The percentage of CD44^(+) MNC and SSM in MRD positive group were significantly higher than those in MRD negative group(P<0.05).In MRD positive group,there were positive correlation between CD44^(+) MNC,SSM and MRD level(r=0.998,r=0.939,P<0.05).The median EFS and OS in HCD44^(+) MNC and HSSM groups were significantly shorter than those in LCD44^(+)MNC and LSSM(P<0.05).CD24^(+) MNC showed no association with MRD and its prognosis.Conclusion:HCD44^(+)MNC and HSSM may be used to predict high level MRD and poor prognosis.