急性白血病化疗24小时体内细胞凋亡预测化疗疗效29例

Predicting the chemotherapeutic efficacy in acute leukemia by cell apoptosis in vivo 24 hours after chemotherapy

目的 :观察体内细胞凋亡和急性白血病化疗的关系 ,为白血病个体化治疗提供早期预测疗效的指标。方法 :采用流式细胞术膜联蛋白 (AnnexinV)法检测 2 9例急性白血病患者化疗前及化疗 2 4h体内细胞凋亡 ,并观察其与患者化疗一疗程疗效之间的关系。结果 :化疗前和化疗 2 4h急性白血病细胞的凋亡率分别为(5 .74± 2 .4 7) %和 (9.77± 3.5 4 ) % ,化疗后凋亡细胞显著增加 (P <0 .0 1)。将完全缓解及部分缓解患者归为有效组 ,未缓解患者归为无效组。有效组化疗 2 4h的细胞凋亡率为 (11.4 5± 3.0 9) % ,细胞凋亡增加 (5 .91±3.4 8) % ;无效组化疗 2 4h的细胞凋亡率为 (8.15± 3.6 6 ) % ,细胞凋亡增加 (2 .2 8± 3.5 8) %。有效组化疗后凋亡增加明显高于无效组 (P <0 .0 5 )。其特异性为 83.3% ,敏感性为 84 .6 %。结论

Objective:To investigate the relationship between apoptosis in vivo and chemotherapy in acute leukemia in order to provide an early index for the prediction of clinical chemotherapy reponse.Method:The in vivo apoptosis before and 24 hours after chemotherapy was detected with flow cytometer by an early apoptosis marker Annexin V.Result:The apoptosis of leukemic cells before chemotherapy was ( 5.74± 2.47)% and obviously increased 24 hours after chemotherapy ( 9.77± 3.54)%,P< 0.001). 12 patients achieved complete remission (CR), 1 partial remission (PR) and 12 non-remission (NR). CR and PR patients were defined as efficient group and NR patients as failure group. The apoptosis rate of efficient group increased ( 5.91± 3.48)% 24 hours after chemotherapy ( 11.45± 3.09)%; the apoptosis rate 24 hours after chemotherapy of failure group was ( 8.15± 3.66)%,and apoptosis cells increased ( 2.28± 3.58)%. Apoptosis induced by chemotherapeutics was significantly increased in the efficient group compared with the failure group (P< 0.05). Its specificity and sensitivity were 83.3% and 84.6% respectively.Conclusion:In vivo aoptosis detected by flow cytometry Annexin V assay is a sensitive and early index to predict clinical efficacy.