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1.
急性非淋巴细胞白血病免疫表型分析   总被引:2,自引:0,他引:2  
本文对一组急性非淋巴细胞白血病(ANLL)检测免疫表型,分析了不同抗原的表达情况,并且对其中部分病例追踪观察化疗后的缓解情况。结果发现,本组ANLL化疗后不能达到完全缓解的有关因素,除多药耐药基因(MDR1、mRNA)高度表达外,尚有CD34抗原阳性表达、CD33/CD13<1及同时表达多种髓系相关抗原。  相似文献   

2.
目的探讨P-糖蛋白(P-glycoprotein,P-gp)在初治老年人急性髓细胞白血病(AML)中的表达特点及其预后意义。方法采用流式细胞术(flowcytometry,FCM)及抗P-gp细胞膜外区域单克隆抗体UIC2检测了37例初治老年人AML白血病细胞P-gp表达。结果16例(43%)患者P-gp阳性(P-gp+),P-gp与干细胞或祖细胞抗原CD34表达显著相关,与其它免疫表型无关。在可评估疗效的32例中,P-gp+15例中的4例(27%)获得完全缓解(CR),缓解率显著低于P-gp阴性(P-gp-)17例中的11例(65%)(P<0.05)。CD34阳性(CD34+)14例中CR3例(21%),也显著低于CD34阴性(CD34-)者18例中12例(67%)(P<0.05)。P-gp-及CD34-13例中11例(85%)获得CR。结论P-gp阳性及CD34阳性是老年人AML预后差的重要指标  相似文献   

3.
P—糖蛋白表达在急性非淋巴细胞白血病中的意义   总被引:7,自引:0,他引:7  
为探讨成人急性非淋巴细胞白血病(ANLL)P-糖蛋白(P-gp)表达及其与临床、生物学特征的关系,用单克隆抗体UIC2及流式细胞术间接免疫荧光法对169例ANLL(初治152例,难治7例,缓解10例)患者P-gp进行检测。结果显示:初治者P-gp表达率为29%,明显低于难治者的71%,而缓解者无P-gp表达。ANLL亚型中以杂合型急性白血病及急性单核细胞白血病表达较高,阳性率分别为67%及47%。P-gp表达与CD34、CD7、CD14或CD42b/CD61高度相关。细胞遗传学研究显示:P-gp在染色体预后差组表达最高(54%),而在预后好组表达低(7%)。P-gp+ANLL的完全缓解率为23%,明显低于P-gp-者的76%。结果提示:P-gp表达是成人初治ANLL化疗耐药的指标,综合免疫分型及核型分析可以更准确地判断预后及指导治疗。  相似文献   

4.
CD34 是造血干祖细胞的特征性表面标记 ,一般认为CD 34急性淋巴细胞白血病预后较好 ,而CD 34 在急性非淋巴细胞白血病 (ANLL)中的表达意义尚不明了 ,我们回顾分析了 12 6例ANLL和 6例急性混合细胞白血病 (AMixL)CD34 、CD7、P170的表达情况 ,对比分析CD 34 和CD-34 两组在初诊时血象、骨髓象、CD7、P170 表达的差异 ,分析了CD34 抗原在ANLL各亚型的分布及对治疗的反应。一、资料和方法1 病例 :男 80例 ,女 5 2例 ,年龄 11~ 82岁 ,中位年龄 37岁 ,其中ANLL 12 6例 ,AMixL 6例。所有患者均符…  相似文献   

5.
急性白血病MDR1与分化抗原关系及其临床意义   总被引:1,自引:0,他引:1  
目的:探讨急性白血病MDR1^+/CD34^+表型的临床意义。方法:采用流式细胞仪及对碘硝基四唑盐(INT)细胞毒检测法,分析了51例初治及17例复发急性白血病患者细胞的表面分化抗原及MDR1^+基因编码的p170阳性率,并用INT法的体外药敏试验进行对照。结果:MDR1^+与CD34^+有显著相关性(r=0.842,P〈0.01),而与CD13、CD14、CD15、CD33、HLA-DR等其它髓系抗原无关;MDR1^+/CD34^+表型细胞较MDR1^-/CD34^-表型细胞缓解率、生存期、缓解期显著缩短。结论:急性白血病MDR1^+/CD34^+表型可作为白血病预后不良的指标。  相似文献   

6.
自体外周血干细胞的动员和采集及其移植效果的研究   总被引:4,自引:0,他引:4  
王良绪  禹涛 《中华内科杂志》1995,34(10):659-662
对22例自体外周血干细胞移植(APBSCT)的三种动员方案、采集方法及移植的外周血干细胞(PBSC)数量与造血重建关系,进行了研究。22例中急性白血病11例,多发性骨髓瘤6例,非何杰金淋巴瘤4例,晚期乳癌1例。三组动员方案:化疗十四氢叶酸+氟美松;化疗+rhGM-CSF(重组人粒巨噬细胞集落刺激因子)+氟美松;化疗+rhG-CSF(重组人粒细胞集落刺激因子)+氟美松。用流式细胞计双染直接免疫荧光法测定rhG-CSF方案组中7例CD34+/CD33 ̄+细胞。结果表明:(1)rhG-CSF方案组的PBSC产率最高,平均每例MNC(单个核细胞)(8.29±6.14)×10 ̄8/kg,CFU-GM(粒单系祖细胞集落生成单位)(21.35±17.24)×10 ̄4/kg。(2)CD34+细胞数与MNC及CFU-GM数大致相关。CD34 ̄+细胞在动员前外周血中多为0或<0.5%,动员后约在用rhG-CSF后6~8天明显增多,就可连续每日采集,如达到≥5×10 ̄5/kg即可停止。(3)采集与回输的PBSC数量是决定造血重建的关键。  相似文献   

7.
CD7阳性急性髓细胞白血病免疫表型及临床特点   总被引:4,自引:1,他引:4  
随着系列单克隆抗体的应用,白血病细胞免疫分型的广泛开展及其研究的深入,伴有CD7抗原表达的急性髓细胞白血病(CD+7AML)不断被发现。有学者认为CD+7AML是一类独特的急性髓细胞白血病亚型,具有与不伴有CD7抗原表达的急性髓细胞白血病(CD-7A...  相似文献   

8.
目的了解细胞程序死亡(PCD)与慢性髓细胞性白血病(CML)急变的关系。方法采用流式细胞术,测定21例CML及12例正常骨髓标本单个核细胞的髓系免疫表型及三种与PCD有关的调节蛋白——c-Myc、Bcl-2、Fas的表达。结果与未治慢性期比较,加速/急变期膜抗原最显著的变化是HLA-DR+%的提高,CD+15%/HLA-DR+%比值倒置。正常骨髓及CML各期HLA-DR+及HLA-DR-细胞几乎均表达c-Myc,差别只在于表达量的多少,未治慢性期与正常骨髓组相似,加速/急变期组不仅显著高于未治慢性期组,其HLA-DR+细胞群的c-Myc表达量亦显著高于正常骨髓组。Bcl-2+%在未治慢性期低于正常骨髓,加速/急变期组显著提高。Fas在CML各期及正常骨髓均为低表达。结论处于未治慢性期的中、晚幼粒细胞的大量聚集似乎与Bcl-2、Fas的PCD调节作用无关;而在加速/急变期组尤其是造血祖细胞不仅有增殖过旺,亦存在PCD受阻  相似文献   

9.
免疫学无法分型的急性白血病细胞表面标记动态分析   总被引:1,自引:0,他引:1  
为探讨缺乏系限抗原表达急性白血病的细胞起源,采用碱性磷酸酶抗碱性磷酸酶免疫酶法(APAAP),分析了25例免疫学无法分型的急性白血病化疗后或复发后细胞表面标记的动态变化。结果:7例单纯表达CD38抗原者,其中2例化疗后、3例复发后表达了T细胞标记;4例单纯表达CD9抗原者,化疗后或复发后均表达了B细胞标记;6例单纯表达HLA-DR抗原者,化疗或复发后各有2例表达了B细胞标记;4例表达CD38和HLA-DR抗原者,各有1例化疗或复发后分别表达了B或T细胞标记;其余4例无任何分化抗原表达者,化疗后各有1例分别表达了T和B细胞标记。细胞表面标记的变异反映了白血病细胞克隆的演化和进展,动态研究有助于白血病细胞起源的判断  相似文献   

10.
MDS患者白细胞介素2受体表达研究   总被引:1,自引:0,他引:1  
本实验以28例MDS(RA18例、RAEB和RAEB-T10例)和10例ANLL为研究对象,采用APAAP和ELISA法检测患者外周血单个核细胞(PHA刺激前后)的MIL-2R和培养血清中STL-IR,结果表明:经PHA刺激培养48h后,MDS和ANLL患者Tac抗原阳性率明显低于正常人(P<0.01)RAEB和RAEB-t组Tac+率比RA低,与ANLL差异无显著性(P>0.05);血清中STL-2R在MDS各亚型中均高于正常对照组(P<0.05),其中以RAEB及RAEB-t为著。认为MDS患者免疫反应及监视能减弱;STR-2R与mIL-2R无相关;IL-2R表达异常可能与造血抑制有关。  相似文献   

11.
BACKGROUND: Granulocyte-macrophage colony stimulating factor (GM-CSF) can affect the treatment of acute non-lymphocytic leukaemia (ANLL) by supporting normal haemopoiesis and by enhancing the proliferation and the maturation of leukaemic cells. METHODS: A human recombinant E. Coli synthesized GM-CSF was administered to 7 patients with ANLL at a dose of 5 or 10 micrograms/kg/day for 7 days, prior to antileukaemic treatment. Peripheral blood neutrophil and blast cell count was monitored daily. Changes in marrow blast cell morphologic features, mitotic index, and the reactivity to a panel of monoclonal antibodies were assessed after 3 and 7 days of treatment. RESULTS: Peripheral blood neutrophil and blast cell count increased in 6/7 cases. The mitotic index of marrow cells increased in 6/7 cases. A significant maturation occurred along the granulocytic line (2 cases) and the monocytic line (1 case). Mild to moderate eosinophilia developed in 3/7 cases. Early stem cell markers (CD 34 and HLA-DR) were not lost, or actually increased. Myelomonocytic markers (CD 33, CD 13, and CD 14) rose and fell. Expression of the multidrug resistance-associated 170 kd glycoprotein remained stable. CONCLUSIONS: These data showed that in vivo GM-CSF more consistently enhanced the proliferation than the maturation of leukaemic cells.  相似文献   

12.
Acute promyelocytic leukemia (FAB-M3) is a distinct entity among acute non-lymphoid leukemias (ANLL) with peculiar morphological, biological, clinical and prognostic features. An atypical form of M3 (M3v) could be confused with other FAB ANLL and therefore the diagnosis of this variant requires ultrastructural analysis and/or cytogenetic study and/or selective gene rearrangement studies. The immunological phenotype of blast cells in 39 APL patients was studied at diagnosis. The diagnosis of M3 FAB type was ascertained in 32 and the diagnosis of M3v in 7 cases. Using a large series of monoclonal antibodies (mAb), the APL blast cells were B and T cell antigens-negative, HLA-DR constantly negative, CD13- and/or CD33-positive, CD9-positive. Among ANLL this phenotype seems to be closely related to APL both in M3 type and M3v subtype. Because the diagnosis of APL (M3 or M3v) is important in order to establish the specific therapeutic approach, the discriminant capacity of the immunological typing to identify M3 and mainly M3v (hypogranular) could be determinant for a "quick" diagnosis.  相似文献   

13.
Determination of peripheral blood stem cells by the Sysmex SE-9500.   总被引:1,自引:0,他引:1  
The Sysmex SE-9500 automated haematology analyser provides an estimate of immature cells, referred to as 'haematopoietic progenitor cells' (HPC). The aim of this study was to evaluate the reliability and usefulness of the SE-9500 HPC parameter as compared with the CD34 + cell count and to determine whether the HPC count was of value in predicting the optimal harvesting time for peripheral blood stem cells (PBSC). Studies were performed on 112 samples from 21 patients with haematological malignancies and 13 healthy donors undergoing progenitor cell mobilisation. Coefficients of variation for the HPC count were 30%, 23.8%, 12.4% and 8.3% respectively for samples with low (4 x 106/l), medium (13 x 106/l), high (250 x 106/l) and very high (2413 x 106/l) counts. There was good linearity for HPC measurement in both peripheral blood (PB) and purified CD34 + cell suspensions (r > 0.995), and no detectable carryover was observed. There was an acceptable correlation between HPC and CD34 + cell counts for PB samples (r=0.669) and for CD34 + cell suspensions (r=0.859). Analysis of purified CD34 + cells using the SE-9500 HPC mode revealed that they appear both in the blast cell area and the immature granulocyte area of the analyser cell display. Quantitation of CD34 + cells and HPC during PBSC mobilisation showed good agreement between these parameters with regard to the optimal time for PBSC harvesting. These findings suggest that HPC counting with the Sysmex SE-9500 may be clinically useful for optimising the timing of PBSC collection.  相似文献   

14.
BACKGROUND. Pluripotent hemopoietic stem cells, progenitors of all hemolymphopoietic lineages, and clonogenic cells from many patients with acute nonlymphocytic leukemia (ANLL) and chronic myeloid leukemia (CML) express the CD34 antigen on their surface. Isolation of these cell populations is of primary experimental and clinical importance. METHODS. Six bone marrow (BM) and 10 peripheral blood (PB) samples were obtained from 2 normal individuals, 3 patients with CML and 9 with ANLL. The CD34+ cell fraction was isolated using MY10 antibody, sheep anti-mouse immunomagnetic beads and the enzyme chymopapain. Indirect immunofluorescence and semisolid culture were employed to evaluate the percentage of CD34+ cells and that of clonogenic cells in each cell fraction. RESULTS. The frequency of CD34+ cells in the original unseparated populations was (mean +/- SE) 24.3 +/- 7.3%, and reached 85.0 +/- 2.7% in the isolated CD34-positive fractions; in the negative fractions it was only 2.7 +/- 1.7%. According to these results, the great majority of clonogenic cells was separated in the CD34-positive fractions and depleted in those CD34-negative. Moreover, chymopapain was shown to be non-toxic to the clonogenic cells. CONCLUSIONS. Positive immunoselection using My10 Ab, immunomagnetic beads and chymopapain is a method for isolating almost pure progenitors from the BM and PB of normal individuals and patients with myeloid leukemias.  相似文献   

15.
Infant leukemia: an analysis of nine Chinese patients   总被引:1,自引:0,他引:1  
A study was made of the cellular and molecular characteristics of nine Chinese infants, consecutively presenting with acute leukemia. Five cases were acute lymphoblastic leukemia (ALL); four were acute nonlymphoblastic leukemia (ANLL). Hyperleukocytosis, hepatosplenomegaly, and poor response to conventional therapy were common features, and CNS involvement was detected at diagnosis in three cases. The blast cells from all five cases with ALL expressed early B-cell markers, i.e., HLA-DR+, CD19+, but CD10-. Terminal deoxynucleotidyl transferase (TdT) was present in blasts from four of the five cases and periodic acid-Schiff staining in blasts from two patients only. The leukemic cells of one patient also showed positive nonspecific esterase activity and expressed myeloid-associated antigens CD33 (My9), CD11 (OkM1), and CD14 (My4 and Mo2). Molecular analysis of leukemic cell DNA from this and two other patients showed rearrangement of the immunoglobulin (Ig) heavy-chain genes, but without any evidence of kappa light-chain gene rearrangement. T-cell receptor (TCR) genes remained in the germline configuration in these cases. Cytogenetic analysis showed translocation t(4;11) (q21;q23) in all four cases studied. In the group of ANLL, three cases belonged to the M4 and one to the M2 subtype. Chromosomal abnormality involving 11q23 was also detected in two patients: t(11;17)(q23;q11) and del(11)(q14q23) in each case respectively. Neither Ig nor TCR gene rearrangement was present in blast cells from patients with ANLL. The data indicate that chromosomal rearrangement of band 11q23 was quite common in Chinese infants with either form of leukemia, a finding that may have pathogenetic implications.  相似文献   

16.
To evaluate the clinical value of the expression of multidrug resistance P-glycoprotein (P-170) on the surface of acute nonlymphoblastic leukemia (ANLL) cells, we analyzed specimens from 150 newly diagnosed patients for staining with MRK16, a monoclonal antibody (MoAb) that binds to an external epitope of P-170. Other surface markers (CD13, CD14, CD15, and CD34) were studied by the same technique. A marker was considered positive when 20% or more cells were stained. Of 150 samples, 71 were P-170-positive. These cases did not differ from P-170-negative cases with regard to age, sex, initial white blood cell (WBC) counts, or French-American-British (FAB) type (except for M3 ANLL, which were more frequently negative). However, leukemias arising from previous myelodysplastic syndrome (MDS) and therapy-induced leukemias were more frequently P-170-positive. CD34 and P-170 expression were significantly associated. All patients were treated by intensive chemotherapy. Complete remission (CR) rates were significantly lower in P-170-positive (23/71, 32%) than in P-170-negative cases (64/79, 81%) (P less than 10(-5)). CD34 positivity was also associated with a low remission rate (P less than 10(-5)). Survival was shorter for P-170- and CD34-positive patients (P less than 10(-5)). The prognostic value of both markers was confirmed in multivariate analysis. CR duration was also shorter for P-170-positive cases, but the difference is less significant (P = .05). It is concluded that P-170 analysis may be an important tool for predicting the outcome of intensive chemotherapy in ANLL patients.  相似文献   

17.
OBJECTIVE: Patients with acute myelogenous leukaemia (AML) show co-existing frequently internal tandem duplications of FLT3 (FLT3-ITD) and mutations of nucleophosmin (NPM1-Mt). We investigated the biological and clinical significance of FLT3-ITD and/or NPM1-Mt in this context. METHODS: We analysed 89 AML patients according to whether NPM1 and FLT3-ITD were single mutants, double mutants, or wild type for both. RESULTS: FLT3-ITD was detected in 19 of 89 patients (21.3%), while NPM1-Mt was detected in 19 of 89 patients (21.3%); eight of 89 patients (9.0%) carried both FLT3-ITD and NPM1-Mt. By multivariate analysis, white blood cell count and peripheral blood blast cell count at diagnosis were significantly higher in patients with FLT3-ITD but not in those with only NPM1-Mt. NPM1-Mt was significantly related to female gender, normal karyotype, and M4 or M5 disease according to French-American-British criteria. In addition, leukaemic blast cells with NPM1-Mt, FLT3-ITD, or both expressed CD34 less frequently than wild-type blasts (P < 0.0001 and P = 0.005 respectively), while myelomonocytic markers such as CD11b and CD14 were expressed more frequently in patients with NPM1-Mt. CONCLUSION: FLT3-ITD may increase potential for cell proliferation to produce a leukaemic population; NPM1-Mt may cause cells to develop along the myelomonocytic lineage. Extensive analyses and detailed experiments will be required to clarify how NPM1 and FLT3 mutations interact in leukaemogenesis.  相似文献   

18.
Modulation of leukaemia blast colony growth by steroid hormones   总被引:1,自引:0,他引:1  
The effect of steroid hormones on in vitro colony growth of human myelogenous leukaemia cells was examined. β-Oestradiol, testosterone and 5-β-dihydrotesterone had little effect on HL60 promyelocytic leukaemia cells or blast colony forming cells (CFC) from eight patients with acute non-lymphocytic leukaemia (ANLL). These compounds inhibited blast colony growth at very high concentrations (10−6-10−4 M). In contrast, hydrocortisone (HC) had highly variable effects on blast colony growth. HL60 cells were resistant to HC at concentrations up to 10−4 M but blast CFC showed a wide range of response. Some patients were resistant to HC at all concentrations tested, while others were inhibited by concentrations as low as 10−8 M. The inhibitory effect of HC was also observed on 3H-TdR incorporation by stimulated peripheral blood blasts. Inhibition by HC was not blocked by progesterone, suggesting this effect was not mediated by specific hormone receptors. These data indicate differences in the response of blast cells in ANLL and normal progenitors to steroid hormones. Cells from patients with ANLL display variable inhibition by HC which is probably not mediated by specific receptors.  相似文献   

19.
Data from 170 consecutive patients aged 19-66 years (median age 46 years) who underwent unmanipulated autologous blood stem cell transplant (ASCT) were analyzed to determine if total CD34+ cells/kg infused, CD34+ subsets (CD34+41+, CD34+90+, CD34+33-, CD34+38-, CD34+38-DR-), peripheral blood CD34+ cell (PBCD34+) count on first apheresis day, or various clinical factors were associated with low blood counts 6 months post ASCT. Thirty-four patients were excluded from analysis either because of death (n = 17) or re-induction chemotherapy prior to 6 months post ASCT (n = 13), or because of lack of follow-up data (n = 4). Of the remaining 136 patients, 46% had low WBC ( < 4 x 10(9)/l), 41% low platelets (<150 x 10(9)/l), and 34% low hemoglobin ( < 120 g/l) at a median of 6 months following ASCT. By Spearman's rank correlation, both the total CD34+ cell dose/kg and the PBCD34+ count correlated with 6 month blood counts better than any subset of CD34+ cells or any clinical factor. The PBCD34+ count was overall a stronger predictor of 6 month blood counts than was the total CD34+ cells/kg infused. Both factors retained their significance in multivariate analysis, controlling for clinical factors. In conclusion, subsets of CD34+ cells and clinical factors are inferior to the total CD34+ cell dose/kg and PBCD34+ count in predicting 6 month blood counts following ASCT.  相似文献   

20.
The Sysmex SE‐9500 automated haematology analyser provides an estimate of immature cells, referred to as ‘haematopoietic progenitor cells’ (HPC). The aim of this study was to evaluate the reliability and usefulness of the SE‐9500 HPC parameter as compared with the CD34 + cell count and to determine whether the HPC count was of value in predicting the optimal harvesting time for peripheral blood stem cells (PBSC). Studies were performed on 112 samples from 21 patients with haematological malignancies and 13 healthy donors undergoing progenitor cell mobilisation. Coefficients of variation for the HPC count were 30%, 23.8%, 12.4% and 8.3% respectively for samples with low (4 × 106/l), medium (13 × 106/l), high (250 × 106/l) and very high (2413 × 106/l) counts. There was good linearity for HPC measurement in both peripheral blood (PB) and purified CD34 + cell suspensions (r > 0.995), and no detectable carryover was observed. There was an acceptable correlation between HPC and CD34 + cell counts for PB samples (r=0.669) and for CD34 + cell suspensions (r=0.859). Analysis of purified CD34 + cells using the SE‐9500 HPC mode revealed that they appear both in the blast cell area and the immature granulocyte area of the analyser cell display. Quantitation of CD34 + cells and HPC during PBSC mobilisation showed good agreement between these parameters with regard to the optimal time for PBSC harvesting. These findings suggest that HPC counting with the Sysmex SE‐9500 may be clinically useful for optimising the timing of PBSC collection.  相似文献   

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