Expressions of IL-10 on leukemic cells in acute leukemic patients and its significance

Objective: To explore the expressions of IL-10 on leukemic cells in acute leukemia patients and its significance.Methods :The expressions of IL-10 on leukemic cells in thirty patients was measured by indirect immunofluorescence technique. Results:Observed yellow-green bright fluorescence on leukemic cells membrane, the positive rote of cells was 10-80%, there were 18 patients expressing IL-10 (18/30, 60% ) positively, among them 11 with ANLL (11/19, 58% ) and 7 with ALL (7/11, 64% ) respectively while that of peripheral mononucleate cells in control group was 13%. Compared with that in the control group, there was a significant increase of positive rote in ANLL and ALL but with no significant difference between ANLL and ALL. Conclusion: IL-10 secreted by leukemic cells, contributed to the immunosuppressive state at the tumor site. This is probably one of the important mechanisms of acute leukemic escape.     

血清IL-8测定在恶性血液病中的临床意义

目的：探讨测定血清白细胞介素-8（IL-8）在恶性血液病诊断及其疗效评价中的意义.方法：57例恶性血液病患者分为急淋（ALL）、急非淋（ANLL）、慢粒（CML）、霍奇金病（HD）和非霍奇金淋巴瘤（NHL）组,分别测定血清IL-8并与正常对照组比较;其中CML组尚进行了治疗前后的比较.结果：各组的血清IL-8水平均高于正常对照组（P＜0.01）;NHL组的血清IL-8水平高于HD组（P＜0.01）和其余各疾病组（P＜0.05）,且经治疗后较治疗前降低（P＜0.05）;HD组的血清IL-8水平低于ALL、ANLL和CML组（P＜0.05）.结论：测定血清IL-8水平可作为恶性血液病的诊断指标,亦可作为区分HD和NHL的参考指标,在CML的病程中观察血清IL-8的动态变化可能有助于对病情变化以及对治疗反应的判断.     

急性白血病患者p53和MGMT基因突变检测

目的：研究p53和MGMT基因突变在急性白血病发病中的意衣以及p53基因突变与MGMT基因突变的关系。方法：应用聚合酶链反应－单莲构象多态性（PCR－SSCP）技术，对36例急性非淋巴细胞白血病（ANLL），26例急性淋巴细胞白血病（ALL）和23例健康对照组骨髓细胞的p53和MGMT基因突变进行了分析。结果：p53基因突变率在ANLL中为16．7％、ALL中为19．2％，MGMT基因突变率在ANLL中为13．9％、ALL中为15．4％；62例急性白血病中有4例为p53和MGMT2个基因同时发生突变；正常对照组均未发生p53和MGMT基因突变。结论：p53和MGMT基因突变在急性白血病发生与发展中起到一定作用，急性白血病中p53基因突变和MGMT基因突变密切相关。     

Bone marrow Th2 cytokine expression as predictor for relapse in childhood acute lymphoblastic leukemia (ALL)

The immunological environment of leukemic blasts in the bone marrow might play a decisive role in determining an individual's risk for relapse. In order to identify potential predictors of relapse and to elucidate the mechanisms of immune control of leukemic blasts we examined the expression of cytokines, costimulatory molecules and members of the TNF family in leukemic marrow samples in a prospective study. Samples from 49 consecutive pediatric patients with B cell precursor acute lymphocytic leukemia (BCP ALL) were analyzed by semiquantitative RT-PCR. We identified interleukin (IL)-10 expression as a significant adverse prognostic indicator in childhood BCP-ALL. The event free survival (EFS) of patients expressing IL-10 mRNA in high quantity was significantly lower compared with patients expressing low IL-10 mRNA. Taqman RT-PCR of sorted cell populations showed that IL-10 mRNA was synthetized almost exclusively by NK or T cells. In addition, we found an increased expression of IL-1, IL-4, CD86 and VEGF mRNA in patients with late relapses. Possibly, ALL cells mediate a Th2 shift through increased expression of CD86 and thereby influence the individual relapse risk. These findings emphasize the role of the immune system for the outcome of childhood ALL.     

乳香提取物诱导急性非淋巴细胞性白血病细胞凋亡的实验研究

目的：研究乳香提取物诱导急性非淋巴细胞性白血病细胞凋亡作用。方法：应用形态学观察、ＤＮＡ电泳、ＤＮＡ片段百分率、流式细胞仪分析检测白血病细胞凋亡。结果：乳香提取物能诱导急性非淋巴性白血病细胞凋亡。结论：乳香提取物具有诱导急非淋白血病细胞凋亡作用     

Terminal deoxynucleotidyl transferase in various immunophenotypic cells in leukemia]

The staining results of terminal deoxynucleotidyl transferase (TdT) in leukemic cells of peripheral blood or bone marrow in 55 patients showed that 22 (40%) patients were found positive for TdT staining: 17 patients with acute lymphoblastic leukemia (ALL), 2 acute non-lymphocytic leukemia (ANLL) and 3 hybrid acute leukemia (HAL). The positive rate of ALL (17/21) was significantly higher than that of ANLL (2/21, P < 0.005). The leukemic cells of HLA-DR+CD19+TdT- were demonstrated to express some of myeloid restricted antigens (HI98, HIM 4, HIM 5) (3/3), which suggested that these cases were leukemias of myeloid origin. None of the 8 patients with M 0/M 1 ANLL was positively stained for the enzyme. Our results showed that TdT detection is of great value in the diagnosis and differentiation of both poorly differentiated and hybrid acute leukemia.     

急性白血病细胞凋亡抑制基因Livin表达及临床意义

目的 观察 Livin 基因在急性白血病(AL)病人白血病细胞中的表达及其临床意义.方法 采用半定量逆转录聚合酶链反应(RT-PCR)方法检测41例不同时期AL病人白血病细胞Livin mRNA的表达水平,以10例健康人作为正常对照.结果 AL病人白血病细胞Livin mRNA 阳性表达率为53.7%.其中急性淋巴细胞白血病(ALL)和急性非淋巴细胞白血病(ANLL)病人Livin mRNA 阳性表达率分别为53.8%、53.6%,二者比较差异无显著性,但均高于正常对照组(10.0%)(P=0.035、0.017).初治和复发AL病人白血病细胞Livin mRNA 阳性表达率分别为52.4%、85.7%,明显高于对照组(P=0.025、0.004).缓解组病人Livin mRNA阳性表达率为15.4%,明显低于初治组和复发组(P=0.004、0.030),而与对照组相比差异无统计学意义.白细胞计数≥50×109/L的初治白血病病人Livin mRNA的阳性表达率(77.8%,7/9)明显高于白细胞计数＜50×109/L的初治病人(25.0%,3/12)(P=0.022),其表达水平也明显高于后者(T=6.50,P<0.05).结论 Livin mRNA过度表达参与了AL的发病,可作为AL的诊断、复发及预后判断的指标之一.Livin mRNA表达在AL细胞的增殖分化和(或) 抗凋亡过程中发挥了重要作用,可能是导致AL细胞对化疗药物不敏感的原因之一,可作为治疗的一个潜在靶点.     

吡柔比星联合化疗缓解成人高危急性白血病的疗效观察

目的 探讨吡柔比星(T)联合化疗缓解成人高危急性白血病的疗效。方法 采用含T药物治疗方案联合化疗治疗高危急性白血病29例。其中急性非淋巴细胞白血病(ANLL)18例、急性淋巴细胞白血病(ALL)8例、混合型白血病3例。选择治疗前条件类同、应用常规化疗方案的配对病例作为对照。实验组给予T A、V T P／V T L P、T A V P(A：阿糖胞苷、V：长春新碱、P：强的松、L：左旋门冬酰胺酶)等联合化疗，对照组给予常规联合化疗。结果 实验组ANLL患者治疗有效率显著高于对照组(77．78％vs44．44％，P=0．031)。实验组的骨髓抑制重于对照组。化疗后白细胞平均最低值、红细胞平均输注量和感染发生率在两组间均存在显著性差异(P分别为0．033、0．049和0．012)。结论 含吡柔比星的药物治疗联合化疗较常规药物联合化疗治疗ANLL有更好的效果，但骨髓抑制明显，感染的发生率高。     

人端粒重复序列结合因子在急性白血病细胞中的表达及与端粒酶活性的关系

目的:研究人端粒重复序列结合因子(TRF1)在30例急性白血病细胞中的表达,了解TRF1表达与急性白血病分型的关系,以及与端粒酶活性的关系.方法:用荧光定量RT-PCR定量检测30例急性白血病细胞中TRF1 mRNA表达情况,同时检测hTERT mRNA的表达,并分析两者之间的相关性.结果:TRF1在急性非淋巴细胞性白血病(ANLL)细胞中的表达0.0126(0.0127～0.0546)明显低于正常人骨髓单个核细胞中的表达0.0457(0.00839～0.262)(P<0.001),但在急性淋巴细胞性白血病(ALL)细胞中的表达0.0745(1.92×10-6～0.193)与正常人骨髓单个核细胞比较差异无显著性,且在ANLL细胞中的表达明显低于ALL细胞中的表达(P=0.001).TRF1和hTERT在急性白血病细胞和正常人骨髓单个核细胞中的表达无显著相关性(r=-0.173,P=0.207).结论:TRF1 mRNA在ANLL细胞中表达明显降低,而在ALL细胞中表达无显著改变,提示ANLL细胞中TRF1可能通过调控端粒长度对端粒酶起间接负调控作用.     

急性白血病患者 W T1 基因m R N A 表达研究

用 Ｒ Ｔ Ｐ Ｃ Ｒ 检测了２８ 例急性白血病患者 Ｗ Ｔ１ 表达水平。结果显示：１９ 例 Ｗ Ｔ１ 表达阳性,阳性率６７９ ％ ;其中１６ 例 Ａ Ｎ Ｌ Ｌ 中有１１ 例表达阳性,１２ 例 Ａ Ｌ Ｌ 有８ 例表达阳性。表明 Ｗ Ｔ１ 在急性白血病中有高度表达,可作为一种新的检测标记物,在白血病疗效观察、判定预后及 Ｍ Ｒ Ｄ 研究中有重要意义。     

Detection of p53 gene mutations in human leukemia by PCR-SSCP analysis and direct nucleotide sequencing

OBJECTIVE: To look for mutations of the p53 gene in leukemic patients and study the relationship between abnormalities in p53 gene and leukemogenesis. METHODS: The peripheral blood and Bone Marrow Samples were collected from 36 patients with various leukemia types including 14 cases of lymphocytic leukemia [8 cases of acute lymphocytic leukemia (ALL), 4 cases of chronic lymphocytic leukemia (CLL), 2 cases of hairy cell leukemia (HCL)] and 22 cases of myelocytic leukemia [11 cases of acute nonlymphocytic leukemia (ANLL), 11 cases of chronic myelocytic leukemia (CML)]. DNA structures of exon 5-8 of the p53 gene were scanned by PCR-SSCP (single strand conformation polymorphism analysis of polymerase chain reaction products). The appropriate DNA fragments were amplified, Purified and sequenced directly. RESULTS: By PCR-SSCP analysis, shifts in electrophoretic mobility of the p53 gene were detected in 3 of 14 patients with lymphocytic leukemia (2 ALL and 1 CLL), but none in 22 patients with myelocytic leukemia including one in blastic crisis. Direct nucleotide sequencing in one patient with ALL showed transition of CTG to CAG at codon 257 of exon 7, resulting in a change of its encoded amino acids from aspartic acid to valine. To our knowledge, the mutation at this codon has not been previously reported hitherto. CONCLUSIONS: The p53 gene mutations are specifically associated with lymphocytic leukemia. Alternations of the p53 gene may play a certain role in leukemogenesis in some cases of lymphocytic leukemia.     

TREATMENT OF ACUTE LEUKEMIA WITH REFAMPIN AND LOW DOSE HARRINGTONINE ANALTSIS OF 14 CASES

We evaluate the efficacy of rifampin combined with low dosr harringtonine in acute leukemia (Group A, acute lymphocytic leukemia (ALL) 6 cases and acute non – lymphocytic leukemia (ANLL) 8 cases) in comparison with the patients treated with low dose harringtoninc only (Group B,8 ALL, and 5 ANLL). The complete remission (CR) rate in Groups A and B was 64.3% and 23.1%, while the median CR duration, 17 months and 8 months respectively, Group A was more effective than Group B. We also consider that rifampin and low dose harringtonine are more applicable for treatment of ANLL patients without peripheral leukocytosis and those complicated with infection.     

急性白血病患者WT1基因mRNA表达研究

用ＲＴ－ＰＣＲ检测了２８例急性白血病患者ＷＴ１表达水显示：１９例ＷＴ１表达一,阳性率６７．９％;其中１６例ＡＮＬＬ中有１１例表达阳性,１２例ＡＬＬ有８例表达阳性。表明ＷＴ１在急性白血病中有高度表达,可作为一种新的检测标记物,在白血病疗效观察、判定预后及ＭＲＤ研究中有重要意义。     

急性非淋巴细胞白血病细胞表面标记

目的 :探讨急性非淋巴细胞白血病的免疫分型。方法 :应用一组单克隆抗体 (单抗 ) ,采用免疫荧光法检测了 90例急性非淋巴细胞白血病 ( ANLL )细胞表面 CD抗原。结果 :ANLL中 ,髓系特异标记表达率最高者为 CD3 3 ,其次为 CD13 ,CD15;M3 型 HIA- DR均阴性 ,CD14 在 M4 ,M5中表达率较高。结论 :CD13 ,CD3 3 ,CD15联合应用可诊断 ANLL;免疫分型在一定程度上有助于 ANLL各亚型的鉴别。     

吡柔比星联合化疗缓解成人高危急性白血病的疗效观察

目的 探讨吡柔比星(T)联合化疗缓解成人高危急性白血病的疗效。方法 采用含T药物治疗方案联合化疗治疗高危急性白血病29例,其中急性非淋巴细胞白血病(ANLL)18例、急性淋巴细胞白血病(ALL)8例、混合型白血病3例,选择治疗前条件类同、应用常规化疗方案的配对病例作为对照。实验组给予T+A、V+T+P/V+T+L+P、T+A+V+P(A:阿糖胞苷、V:长春新碱、P:强的松、L:左旋门冬酰胺酶)等联合化疗,对照组给予常规联合化疗。结果 实验组ANLL患者治疗有效率显著高于对照组(77.78%vs 44.44%,P=0.031)。实验组的骨髓抑制重于对照组,化疗后白细胞平均最低值、红细胞平均输注量和感染发生率在两组问均存在显著性差异(P分别为0.033、0.049和0.012)。结论 含吡柔比星的药物治疗联合化疗较常规药物联合化疗治疗ANLL有更好的效果,但骨髓抑制明显,感染的发生率高。     

白血病细胞促凝活性的研究

本文检测34例急性白血病完整与破碎白血病细胞的促凝活性。26例急性非淋巴细胞白血病(ANLL)均无弥散性血管内凝血(DiC)依据,其完整白血病细胞的促凝活性增加,尤以M_5型为明显,而8例急性淋巴细胞白血病的完整白细胞均无促凝活性。破碎白血病细胞均无促凝活性。我们认为用细胞毒药物快速破坏白血病细胞仍是有效防止DIC的措施之一,若合用肝素可能更好。     

急性白血病扫描电镜观察及其临床意义

用扫描电镜（ＳＥＭ）研究了２６例急性白血病细胞表面形态特征，同时结合光镜形态学（ＦＡＢ）、免疫学和细胞遗传学分型（ＭＩＣ），结果发现，ＳＥＭ可更准确地区分急性淋巴细胞白血病（ＡＬＬ）和急性非淋巴细胞白血病（ＡＮＬＬ）。在ＡＮＬＬ中，白血病粒细胞以表面横嵴为特征，白血病单核细胞以基底宽的膜性皱起为特征，ＳＥＭ观察结果与ＭＩＣ分型符合率为９０．５％。在ＡＬＬ病例中，ＳＥＭ区分其免疫亚型有一定局限性。ＡＮＬＬ的疗效与ＳＥＭ下白血病细胞的分化程度可能相关。     

急性白血病患者血清sFas、TNFa水平及其与治疗效果的关系

为了解急性白血病患者血清sFas和TNFa水平及其意义 ,用酶联免疫吸附法测定血清sFas,用放免法测定TNFa水平 ,共 6 2例急性白血病患者 ,其中ALL2 5例 ,ANLL37例。结果显示 :ALL和ANLL患者sFas水平均明显高于对照组 ,治疗后CR患者其水平明显降低 ,PR和NR患者其血清sFas仍处于高水平。急性白血病患者的血清TNFa变化与sFas相似 ,治疗前明显增高 ,并随治疗后CR而降低 ,但与sFas无直线相关。提示治疗前测定血清sFas和TNFa水平有助于指导治疗方案的选择 ,动态监测二者变化有助于疗效判断。     

玉溪地区小儿急性白血病85例

目的：分析和了解玉溪地区小儿急性白血病的发病、地区分布及类型。方法：收集、整理和分析１９８３年４月至１９９８年４月间我院诊断的小儿急性白血病。结果：１５年间诊断的小儿急性淋巴细胞白血病Ｌ１～２型５０例,急性非淋巴细胞白血病Ｍ２～６型３５例。占同期住院小儿总数的０２０５％,男∶女＝１２４∶１。结论：４～９岁发病高。急淋高于急非淋,以Ｌ１型多见。高白细胞白血病占１１７６％（＞１００×１０９／Ｌ）。地区分布以玉溪市发病最高占３７６５％     

急性白血病患者血小板输注疗效研究

目的 探讨急性白血病患者反复输注血小板的治疗效果。方法 对７１例急性白血病反复输血及佃血小板的患者,采用淋巴细胞毒试验检测,研究这组患者的血小板校正增加值与之间的关系。结果 血小板输注有效的急性淋巴细胞白血病及急性非淋巴细胞白血病检测ＬＣＴ阳性率分别为７．６％及４．２％;血小板输注无效的ＡＬＬ及ＡＮＬＬ的ＬＣＴ阳性率分别为７１．４％及４８．８％。