急性粒细胞白血病化疗与体内细胞凋亡的关系

为了解白血病患者化疗期间发生体内细胞凋亡的状况。利用原位末端转移酶（ＴｄＴ）双荧光细胞流式仪法及ＤＮＡ阶梯凝胶电泳法，对１０例临床白血病患者化疗前、化疗间、化疗后的外周血单个核细胞进行了细胞凋亡的研究。结果显示：化疗前均无明显的细胞凋亡（０～２．９％），获得完全缓解和部分缓解的患者化疗期间（化疗３０～７２小时）凋亡细胞明显增高（１１．４％～７２．０％），化疗后基本未检测到凋亡细胞（０～２．９％），而４例化疗期间凋亡细胞很少出现者未达到缓解，说明有效药物才能导致细胞凋亡。用ＤＮＡ阶梯凝胶电泳法患者化疗前、中、后均未检测到ＤＮＡ“阶梯”，所以这种方法检测体内的细胞凋亡不够敏感。用原位ＴｄＴ荧光流式细胞仪，分析观察体内细胞凋亡有可能成为早期观察临床患者用药疗效的指标。

A study on relationship between chemotherapy of acute leukemia and apoptosis in vivo]

In order to investigate whether apoptosis occurs in vivo in patients with leukemia in different stage (before, during and after chemotherapy). We detect apoptosis of peripheral blood leukemia cells in 10 patients before, during and after chemotherapy with in situ TdT fluorescence measurement and DNA electrophoresis. The results showed that apoptotic cells were few (0-2.9%) before chemotherapy, increased obviously (11.4%-72.0%) during chemotherapy in patients with complete remission (CR) or partial remission (PR), but decreased (0-2.9%) after chemotherapy (10-14 days). Apoptotic cells were few (0-5.7%) during chemotherapy in four patients without remission. Therefore, only effective drug therapy could induce apoptosis. DNA ladder cannot be detected by agarose gel electrophoresis either before, during and after chemotherapy. So we considered that in situ TdT assay is possible to apoptosis in vivo in the early course of chemotherapy for immediate modification of chemotherapy, while electrophoretic analysis is not sensitive enough to detect apoptotic cells in vivo.