Objective: To study the characteristics of immunophenotype in acute lymphoblastic leukemia (ALL) and its clinical significance. Methods: Immunophenotyping was performed on 81 ALL patients by three-color flow cytom...Objective: To study the characteristics of immunophenotype in acute lymphoblastic leukemia (ALL) and its clinical significance. Methods: Immunophenotyping was performed on 81 ALL patients by three-color flow cytometry analysis using CD45/SSC gating, meanwhile the cytogenetic analysis was performed on 45 cases out of 81 ALL patients. Results: (1) CD19 was the most commonly expressed of all B-lineage antigens detected with the positive rate being 100%. In T-ALL, the positive expression rate of CD5 and CD7 was the highest, being 90%. Both B-ALL and T-ALL overlapped in expression of lineage antigens. There was no significant difference in the complete remission rate (CR rate) between T-ALL and B-ALL. (2) The incidence of ALL with rayeloid antigens expression (My+ALL) was 39.5%. CD13 was most often seen among the myeloid markers. My+ALL always involved in B-lineage antigens and the CR rate in children and adults was 72.2% and 78.6% respectively. (3) The incidence of HAL was 19.8%. Coexpression of B-lineage and myeloid-assoeiated antigens was the commonest subtype in HAL. The expression of CD34 was commonly seen in HAL patients (81.3%). The CR rate was low in HAL, 50% for children and 40% for adults. (4) Compared to T-ALL, B-ALL, My+ALL, and HAL had a higher positive rate of CD34 expression with the difference being significant (P〈0.025). Conclusion: Immunophenotyping had remarkable predominance in diagnosing special category of ALL (such as HAL and My+ALL); CD19 and CD5 were highly sensitive in diagnosing B-ALL and T-ALL, but less special, and overlapping was found in expression. No significant association was found between the expression of CD34 or myeloid antigens and CR rate, while low CR rate was found in HAL patients, especially for those coexpressing CD34 antigen.展开更多
In acute myeloid leukemia(AML),a small cell population that contains stem cell features such as lack of differentiation,self-renewal potential,and drug resistance,can be identified.These so-called leukemic stem cells(...In acute myeloid leukemia(AML),a small cell population that contains stem cell features such as lack of differentiation,self-renewal potential,and drug resistance,can be identified.These so-called leukemic stem cells(LSCs)are thought to be responsible for relapse initiation after initial treatment leading to successful eradication of the bulk AML cell population.Since many studies have aimed to characterize and eliminate LSCs to prevent relapse and increase survival rates of patients,LSCs are one of the best characterized cancer stem cells.The specific elimination of LSCs,while sparing the healthy normal hematopoietic stem cells(HSCs),is one of the major challenges in the treatment of leukemia.This review focuses on several surface markers and intracellular transcription factors that can distinguish AML LSCs from HSCs and,therefore,specifically eliminate these stem cell-like leukemic cells.Moreover,previous and ongoing clinical trials of acute leukemia patients treated with therapies targeting these markers are discussed.In contrast to knowledge on LSCs in AML,insight into LSCs in acute lymphoid leukemia(ALL)is limited.This review therefore also addresses the latest insight into LSCs in ALL.展开更多
文摘Objective: To study the characteristics of immunophenotype in acute lymphoblastic leukemia (ALL) and its clinical significance. Methods: Immunophenotyping was performed on 81 ALL patients by three-color flow cytometry analysis using CD45/SSC gating, meanwhile the cytogenetic analysis was performed on 45 cases out of 81 ALL patients. Results: (1) CD19 was the most commonly expressed of all B-lineage antigens detected with the positive rate being 100%. In T-ALL, the positive expression rate of CD5 and CD7 was the highest, being 90%. Both B-ALL and T-ALL overlapped in expression of lineage antigens. There was no significant difference in the complete remission rate (CR rate) between T-ALL and B-ALL. (2) The incidence of ALL with rayeloid antigens expression (My+ALL) was 39.5%. CD13 was most often seen among the myeloid markers. My+ALL always involved in B-lineage antigens and the CR rate in children and adults was 72.2% and 78.6% respectively. (3) The incidence of HAL was 19.8%. Coexpression of B-lineage and myeloid-assoeiated antigens was the commonest subtype in HAL. The expression of CD34 was commonly seen in HAL patients (81.3%). The CR rate was low in HAL, 50% for children and 40% for adults. (4) Compared to T-ALL, B-ALL, My+ALL, and HAL had a higher positive rate of CD34 expression with the difference being significant (P〈0.025). Conclusion: Immunophenotyping had remarkable predominance in diagnosing special category of ALL (such as HAL and My+ALL); CD19 and CD5 were highly sensitive in diagnosing B-ALL and T-ALL, but less special, and overlapping was found in expression. No significant association was found between the expression of CD34 or myeloid antigens and CR rate, while low CR rate was found in HAL patients, especially for those coexpressing CD34 antigen.
文摘In acute myeloid leukemia(AML),a small cell population that contains stem cell features such as lack of differentiation,self-renewal potential,and drug resistance,can be identified.These so-called leukemic stem cells(LSCs)are thought to be responsible for relapse initiation after initial treatment leading to successful eradication of the bulk AML cell population.Since many studies have aimed to characterize and eliminate LSCs to prevent relapse and increase survival rates of patients,LSCs are one of the best characterized cancer stem cells.The specific elimination of LSCs,while sparing the healthy normal hematopoietic stem cells(HSCs),is one of the major challenges in the treatment of leukemia.This review focuses on several surface markers and intracellular transcription factors that can distinguish AML LSCs from HSCs and,therefore,specifically eliminate these stem cell-like leukemic cells.Moreover,previous and ongoing clinical trials of acute leukemia patients treated with therapies targeting these markers are discussed.In contrast to knowledge on LSCs in AML,insight into LSCs in acute lymphoid leukemia(ALL)is limited.This review therefore also addresses the latest insight into LSCs in ALL.