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目的:探讨急性白血病(AL)患者骨髓中CD34~+、CD38~-、CD123~+表型与AL疗效及预后的关系。方法:选取2010年1月至2011年7月经本院收治的初诊AL患者77例,采用三色流式细胞术检测患者免疫表型及细胞群CD34~+细胞的百分比。对各型AL患者给予对症化疗治疗,随访24~40个月,记录患者生存情况。结果:77例患者中,有31例CD123表达阳性,占40.26%;阳性细胞占有核细胞的比例为1%~90.04%,在CD34~+、CD38~-细胞亚群中,CD123~+的平均表达水平为36.17%。化疗2个疗程后,CD123~+表达阳性患者有效率为51.61%,显著低于表达阴性患者的73.91%,差异具有统计学意义(P<0.05)。对患者随访2年,结果发现CD123表达阳性患者1、2年生存率及生存时间均显著低于表达阴性患者,差异具有统计学意义(P<0.05)。结论:CD34~+、CD38~﹣、CD123~+表型能有效反映急性白血病疗效及预后,有望作为白血病干细胞(LSC)公认的特异标志。
Objective: To investigate the relationship between the expression of CD34 ~ +, CD38 ~ - and CD123 ~ + in the bone marrow of patients with acute leukemia (AL) and their efficacy and prognosis. Methods: From January 2010 to July 2011, 77 newly diagnosed AL patients admitted to our hospital were enrolled. Tricolor flow cytometry was used to detect the immunophenotype and the percentage of CD34 ~ + cells. All types of patients with symptomatic AL were given chemotherapy, followed up for 24 to 40 months, record the patient’s survival. Results: Of the 77 patients, 31 were positive for CD123, accounting for 40.26%; the percentage of positive cells in nucleated cells was 1% ~ 90.04%. The average of CD123 ~ + in CD34 ~ + and CD38 ~ - cell subsets was The expression level was 36.17%. After 2 cycles of chemotherapy, the positive rate of CD123 ~ + expression was 51.61%, which was significantly lower than that of negative expression (73.91%), the difference was statistically significant (P <0.05). The patients were followed up for 2 years. The results showed that the 1-year and 2-year survival rates of patients with positive expression of CD123 and their survival time were significantly lower than those with negative expression (P <0.05). Conclusion: CD34 ~ +, CD38 ~ - and CD123 ~ + phenotypes can effectively reflect the therapeutic effect and prognosis of acute leukemia, which is expected to be recognized as a specific marker of leukemia stem cells (LSC).