骨髓TPO及受体c-MPL表达变化在急性髓系白血病化疗中的意义

目的探讨急性髓系白血病化疗前后骨髓血小板生成素（Thrombopoietin，TPO）及受体c-MPL的变化及其意义。方法  采用ELISA法和流式细胞仪检测急性髓系白血病初治患者化疗前、化疗缓解后及复发患者骨髓TPO以及c-MPL的表达水平。结果  AML初治患者化疗前骨髓TPO及c-MPL的表达分别为（162.21±39.92）ng/ml、（6.04±4.072）%，明显低于复发组的（213.19±48.34）ng/ml、（11.23±5.225）%，化疗前及复发组均明显高于对照组的（122.14±25.75）ng/ml、（2.84±0.724）%；AML患者化疗缓解后TPO及c-MPL的表达分别为（115.82±22.32）ng/ml、（2.81±1.306）%，与对照组比较差异无统计学意义（P>0.05）。各组骨髓TPO与c-MPL的表达呈正相关性。结论 （1）TPO及c-MPL的高表达对AML的诊断具有提示意义，化疗后TPO及c-MPL降至正常，可作为评判AML化疗效果及是否缓解的重要指标；（2）TPO及c-MPL在复发患者骨髓细胞中的表达较初发AML白血病患者明显增高，提示TPO/c-MPL信号通路的高表达可能与急性髓系白血病治疗后复发及难治相关。

Significance of Expression of Marrow Thrombopoietin and Its Receptor c-MPL before and after Chemotherapy in Acute Myeloid Leukemia

Objective To study the expression and the signification of marrow TPO and its receptor c-MPL in acute myeloid leukemia relapse after chemotherapy.Methods The expression of TPO and c-MPL of newly diagnosed acute myeloid leukemia patients before chemotherapy,complete remission after chemotherapy and its relapse was detected by using ELISA and flow cytometry,respectively.Results The expression of bone marrow TPO and c-MPL before chemotherapy was(162.21±39.92)ng/ml and(6.04±4.072)%,it was lower than the(213.19±48.34)ng/ml,(11.23±5.225)% of relapse group siglificantly.The expression of bone marrow TPO and c-MPL before chemotherapy and relapse group were significantly higher than(122.14±25.75)ng/ml,(2.84±0.724)% of control group.The expression of bone marrow TPO and c-MPL of remission group was(115.82±22.32)ng/ml and(2.81±1.306)%.The expression of marrow TPO and c-MPL between chemotherapied AML patients and normal group was no significant difference(P>0.05).The expression of bone marrow TPO was positively correlated with c-MPL.Conclusion(1)The high expression of bone marrow TPO and its receptor c-MPL may be associated with the relapse of acute myeloid leukemia after treatment.(2) The expression of bone marrow TPO and c-MPL was significantly higher in relapse group than before chemotherapy.It suggested that TPO/c-MPL signaling pathway may play an important role in acute myeloid leukemia relapse and refractory after treatment.