儿童白血病细胞DNA含量及细胞周期的临床分析

目的:探讨小儿急性白血病(AL)患者骨髓细胞周期分布与分型和治疗的关系。方法:应用图像分析系统测定96例小儿AL骨髓单个核细胞DNA含量和细胞周期。结果:不同类型的AL异倍体发生率不同,急性淋巴细胞白血病(ALL)异倍体率55.7%(44/79),明显高于急性非淋巴细胞白血病(ANLL)的29.41%(5/17),T-ALL异倍体率(77.42%)明显高于B-ALL(41.67%),统计学差异均有显著意义。AL初诊病例和复发病例的G0/G1期细胞比例高于完全缓解组和对照组,G2M+S期比例低于完全缓解组和对照组(P<0.05),完全缓解组和对照组无显著差异。结论:图像分析系统对AL尤其是ALL异倍体的分析,有利于判断高危ALL,对细胞周期的测定给化疗个体化提供了具体的参考指标。

Clinical implication of DNA content assay and cell cycle distribution in childhood acute leukemia

Objective:To investigate the distribution of marrow cell cycle and the relationship with the types of leukemia and therapeutic effects in childhood acute leukemia (AL).Methods:Mononuclear cellular DNA contents in bone marrow were assessed by image analysis system in 96 patients with childhood AL.Results:The proportion of patients with DNA-aneuploid was different in the various types of AL:DNA-aneuploid in the patients with ALL was 55.7%(44/79), much higher than that in the children with ANLL (29.41%, 5/17) .Statistically significant differences were found between the T-ALL group and B-ALL group in the DNA- aneuploid rate (77.42% vs 41.67%,P<0.05) . The leukemia cell cycle distribution indicated that G0/G1-phase compartment in untreated group and relapsed group were higher than in complete remission group and normal controls, G2 M+S-phase compartment were lower than in complete remission group and normal controls (P<0.05). There were no significant differences in cell cycle distribution between complete remission group and normal controls.Conclusion:The analysis of AL, especially ALL aneuploid, by image analysis system can be helpful in distinguishing the high risk ALL from the standard risk ALL ,and the determination of cell cycle distribution can provide a crucial reference data for chemotherapy.