不同步或跨系表达抗原检测儿童急性B淋巴细胞白血病微小残留病

目的探讨多参数流式细胞术(FCM)对儿童急性B淋巴细胞白血病(B-ALL)微小残留病(MRD)的应用价值。方法基于急性B淋巴细胞白血病初诊免疫表型特点,确定一到两组四色抗体,加用抗原跨系表达抗体组合CD45/CD19/CD10/CD13或抗原不同步表达相结合的抗体组合CD45/CD19/CD22/CD34,对20例完全缓解后的急性B淋巴细胞白血病患儿进行MRD定期检测。同时以非白血病患儿为对照,探讨CD45/SSC设门,CD45/CD19/CD10/CD34抗体组合检测MRD的有效性。结果20例B-ALL患儿中,90%患儿初诊时存在CD45、CD34、CD19、CD10表达量的异常。CD45/CD19/CD10/CD34抗体组合表达以≥0.03%为界与对照组比较,差异有统计学意义(P<0.05)。其中CD45/CD19/CD10/CD34、CD45/CD19/CD10/CD13、CD45/CD19/CD22/CD34三组抗体组合发生频率最高,分别为40%、35%和30%。结论CD45/SSC设门,CD45/CD10/CD34可作为B-ALL患儿MRD检测的有效抗体组合。根据B-ALL患儿初诊异常免疫表型特点,确定一至两组四色抗体组合,再加用抗原跨系表达抗体组合或抗原不同步表达相结合的抗体组合,用于检测MRD,既能使检测个体化又可避免假阴性。

Cross-lineage antigen expression and maturational asynchronous antigen expression in detecting minimal residual disease in childhood B-lineage acute lymphoblastic leukemia

Objective To evaluate the clinical applicable value of multiparameter flow cytometry(FCM)in screening minimal residual disease(MRD)of childhood B-lineage acute lymphoblastic leukemia(B-ALL).Methods Twenty childhood B-ALL patients who achieved complete remission were involved in the study.On the basis of the onset immunophenotypes of the patients with B-ALL,one or two panels of 4-color antibodies were selected.By using FCM,Cross-lineage antigen expression and maturational asynchronous antigen expression were used to detect MRD of the 20 patients.As control,10 childhood patients without leukemia were selected.Results At the onset of B-ALL,90 percent of patients overexpressed CD45,CD34,CD19 and CD10.As to antibody combination expression of CD45/CD19/CD10/CD34,there was significant difference between patients and control(P<0.05).The frequency of the following 3 type of antibody combination expression,such as CD45/CD19/CD10/CD34,CD45/CD19/CD10/CD13 and CD45/CD19/CD22/CD34 was 40%,35% and 30%,respectively,which were higher than that of other types of antibody combinations expression.Conclusions Antibody combination expression of CD45/CD19/CD10/CD34 is appropriate to detect MRD of childhood B-ALL.According to the onset immunophenotypes of the patients with B-ALL,one or two panels of 4-color antibodies,as well as cross-lineage antigen expression and maturational asynchronous antigen expression are available in screening MRD of childhood B-ALL.The false negative also can be controlled.