体外化疗药物诱导白血病细胞凋亡预测临床疗效

Clinical Response Predicting with Apoptosis of Leukemic Cells Induced by Chemotherapeutic Agents in Vitro

[目的]探讨急性髓系白血病(AML)患者体外化疗药物诱导白血病细胞凋亡在化疗疗效预测中的价值。[方法]应用TdT介导的脱氧核苷酸切口和末端标记法(Tunel)、单克隆抗体免疫组化检测等方法研究42例初治AML患者体外化疗药物诱导白血病细胞凋亡、bcl鄄2表达与临床化疗疗效的关系。[结果]42例AML患者中,30例获完全缓解(CR)者,bcl鄄2表达显著低于12例未缓解(NR)者(P<0.05);CR患者柔红霉素(DNR)和阿糖胞苷(Ara鄄C)体外诱导白血病细胞凋亡率均分别高于NR患者,差异有显著性(P均<0.05);体外DNR和Ara鄄C两药诱导白血病细胞的总凋亡率,可以作为临床预测AML患者DA方案疗效的定量指标。[结论]体外化疗药物能否有效地诱导白血病细胞凋亡是判断AML患者化疗敏感性的重要指标。

To explore the value of apoptosis induced by chemotherapeutic agents in vitro for predicting of chemotherapeutic response in the patients with acute myeloid leukemia.Apoptosis induced by chemotherapeutic agents in vitro was detected by Tunel assay,and the level of bcl-2expression was measured by immunohistochemistry.The relationship between apoptosis of leukemic cells in vitro and chemotherapeutic effect in vivo was analyzed in42patients with acute myeloid leukemia.Apoptotic rate of30patients with complete remission(CR)induced by any one of daunorubicin(DNR)or cytosine arabinoside(Ara-C)was higher than apoptotic rate of12patients with nor-remission(NR).The expression of bcl-2in the patients with CR was lower than the expression in the patients with NR(P<0.05).Overall apoptotic rate induced by DNR and Ara-C in vitro could be a quantitive index as to predict clinical response to regimen of DA in patients with acute myeloid leukemia.[Conclusion]Apoptot-ic level induced by chemotherapeutic agents in vitro could be an important index to predict chemothera-peutic sensitivity of the patients with acute myeloid leukemia.