紫草素调节有氧糖酵解代谢诱导急性淋巴细胞白血病细胞凋亡

目的:探讨紫草素通过调节白血病细胞能量代谢影响细胞增殖与凋亡的具体机制。方法:采用MTS法检测细胞增殖,流式细胞术检测细胞凋亡;采用Western blotting 法检测细胞凋亡相关蛋白的表达,包括cleaved-caspase 8、cleaved-PARP、cleaved-caspase 3。利用丙酮酸激酶（PK）活性检测试剂盒评估紫草素对PK酶活性的影响;利用海马能量代谢检测仪检测Reh细胞经紫草素处理后其有氧糖酵解代谢水平的变化。结果:紫草素以时间剂量依赖性的方式抑制白血病细胞增殖,并诱导白血病细胞凋亡,凋亡率与药物剂量呈正相关关系（P＜0.01）。紫草素激活caspase级联反应,凋亡相关蛋白cleaved-caspase 8、cleaved-PARP及cleaved-caspase 3的表达随紫草素的剂量增加而增加。紫草素抑制白血病细胞PK酶的活性,并抑制有氧糖酵解代谢的代偿能力（P＜0.001）。结论:紫草素抑制急性淋巴细胞白血病Reh细胞有氧糖酵解代谢的代偿能力,并诱导Reh细胞以caspase依赖性的方式凋亡。     

T细胞急性淋巴细胞白血病对肿瘤坏死因子相关的凋亡诱导配体的敏感度研究

目的观察T细胞急性淋巴细胞白血病（T-ALL）对肿瘤坏死因子（TNF）相关的凋亡诱导配体(TRAIL)所介导的细胞毒的敏感度,并探讨其机制。方法以T-ALL细胞株3株及原代细胞为研究对象,通过测定细胞表面TRAIL受体表达、TRAIL作用后细胞的存活率及凋亡,观察T-ALL对TRAIL的敏感性。结果T-ALL细胞对TRAIL中度至高度耐受,其原因主要是细胞表面凋亡受体表达低下。 结论T-ALL对TRAIL耐受,有可能是T-ALL迅速克隆扩增及GVL效应差的一个重要机制。     

土贝母苷甲对人HL-60髓性白血病细胞周期与凋亡的影响

目的:研究土贝母苷甲(下称苷甲)对人髓性白血病细胞HL-60的细胞周期及凋亡的影响。方法:采用MTT(四甲基偶氮唑蓝)法检测苷甲对HL-60细胞生长的影响;形态学方法(荧光显微镜和透射电镜)、流式细胞仪和DNA琼脂糖凝胶电泳观察和分析在苷甲作用下HL-60细胞形态、DNA含量的变化和DNA断裂的情况;蛋白印迹免疫法检测细胞凋亡及周期相关基因bcl-2、cyclinB1表达的变化。结果:苷甲显著抑制HL-60细胞的生长,其抑制效果与浓度及时间呈依赖关系。15μmol·L-1苷甲作用24小时可将HL-60细胞阻滞于G2/M期,进而诱导其凋亡,凋亡细胞具有典型的凋亡形态特征,琼脂糖凝胶电泳可见明显的梯状区带。bcl-2表达无明显变化,cyclinB1表达降低。结论:苷甲对细胞周期起阻滞作用,并诱导其凋亡,其作用机制可能与cyclinB1表达降低有关。     

儿童急性淋巴细胞性白血病并发中枢神经系统白血病的临床治疗研究

目的：探讨儿童中枢神经系统白血病复发再治疗的安全有效方法。方法：应用国产^60Co，对27例曾接受全颅、全脊髓放射治疗和(或)鞘内注射后CNSL复发的儿童急性淋巴细胞性白血病进行全颅、全脊髓间歇性放射治疗，并联合鞘内注射。治疗方案为：全颅1.5Gy／次 全脊髓0．75Gy／次，1次／d照射3d。第1天鞘内注射甲氨蝶呤(MTX)8～12mg/m^2，阿糖胞苷(Ara—C)25mg/m^2．地塞米松(DXM)2～5mg/次，以后每8周全颅1．5Gy 全脊髓0．75Gy照射1次，当天鞘内注射，用药剂量同前。总疗程为2年2个月。结果：27例患者中，3年内死于骨髓复发4例、CNSL复发2例；3～5年内死于骨髓复发5例、CNSL复发8例．3、5年生存率分别为77．8％(21/27)、25．9％(7/27)。间歇性放射治疗过程中未发现明显急性毒副反应。随访期间发现5例记忆力差、注意力不易集中现象。结论：间歇性放射治疗联合鞘内注药对于曾接受全中枢神经系统放射治疗和(或)鞘内注射后CNSL复发的儿童急性淋巴细胞性白血病安全而有效。     

microRNA与急性淋巴细胞性白血病关系的研究进展

microRNA是一类长度为19～25个核苷酸的内源性非编码小分子RNA,通过抑制靶基因的表达参与包括细胞增殖、分化、凋亡、炎症调节、干细胞发育等几乎所有重要的生物学过程,许多microRNA在肿瘤细胞中异常表达,提示可能与肿瘤的发生发展有关。急性淋巴细胞性白血病（ALL）是最常见的儿童肿瘤,临床表现、形态学、免疫表型及遗传学特征极具异质性。现已发现若干microRNA在ALL 中异常表达,且与其生物学特性以及临床特征、预后和治疗相关。对microRNA的了解有助于帮助人们更深入地认识ALL 的发病机理,有助于在寻找合适的诊断、判定预后的分子标志物以及潜在的治疗靶点方面取得新突破。      

儿童急性淋巴细胞性白血病并发中枢神经系统白血病的临床治疗研究

目的 :探讨儿童中枢神经系统白血病复发再治疗的安全有效方法。方法 :应用国产 60Co ,对 2 7例曾接受全颅、全脊髓放射治疗和 (或 )鞘内注射后CNSL复发的儿童急性淋巴细胞性白血病进行全颅、全脊髓间歇性放射治疗 ,并联合鞘内注射。治疗方案为 :全颅 1 5Gy/次 全脊髓 0 75Gy/次 ,1次 /d照射 3d。第 1天鞘内注射甲氨蝶呤 (MTX ) 8～ 12mg/m2 ,阿糖胞苷 (Ara C) 2 5mg/m2 ,地塞米松 (DXM ) 2～ 5mg/次 ,以后每 8周全颅1 5Gy 全脊髓 0 75Gy照射 1次 ,当天鞘内注射 ,用药剂量同前。总疗程为 2年2个月。结果 :2 7例患者中 ,3年内死于骨髓复发 4例、CNSL复发 2例 ;3～ 5年内死于骨髓复发 5例、CNSL复发 8例 ,3、5年生存率分别为 77 8% (2 1/2 7)、2 5 9%(7/2 7)。间歇性放射治疗过程中未发现明显急性毒副反应。随访期间发现 5例记忆力差、注意力不易集中现象。结论 :间歇性放射治疗联合鞘内注药对于曾接受全中枢神经系统放射治疗和 (或 )鞘内注射后CNSL复发的儿童急性淋巴细胞性白血病安全而有效。     

PTEN基因对急性淋巴细胞白血病细胞增殖、侵袭的影响

目的:观察第10号染色体同源缺失性磷酸酶-张力蛋白同源的基因（PTEN）对急性淋巴细胞白血病细胞增殖、侵袭的影响。方法:在人急性淋巴细胞白血病细胞CEM-C1中转染PTEN过表达载体（pBP-PTEN）,同时转染对照载体（pBP）,以没有转染的细胞作为对照,RT-PCR和Western blot检测转染后细胞中PTEN的水平;MTT和集落形成试验检测细胞增殖能力;Transwell小室检测细胞侵袭和迁移能力;Western blot检测PTEN、基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶-9（MMP-9）、p38丝裂原活化蛋白激酶（p38MAPK）、磷酸化的p38MAPK（p-p38MAPK）的水平。结果:转染对照载体的CEM-C1细胞中PTEN水平、细胞光密度（OD）值、克隆形成数目、侵袭数目、迁移数目及PTEN、MMP-2、MMP-9、p38MAPK、p-p38MAPK水平与未转染细胞相比没有明显变化（P＞0.05）。转染PTEN过表达载体后的CEM-C1细胞中PTEN水平和p-p38MAPK水平升高,细胞OD值、克隆形成数目、侵袭数目、迁移数目和MMP-2、MMP-9水平降低,与未转染细胞相比差异具有统计学意义（P＜0.05）。结论:PTEN抑制急性淋巴细胞白血病细胞增殖、侵袭及迁移,促进p38MAPK信号通路激活。     

淋巴瘤细胞性白血病和急性淋巴细胞性白血病的特征及其鉴别诊断(附160例分析)

本文报告79例淋巴瘤细胞性白血病(LMCL)和81例急性淋巴细胞性白血病(ALL)的临床研究结果。临床上LMCL和ALL极易混淆。但ALL组在发热、出血及贫血等临床表现,明显的比LMCL组严重,ALL组发热、出血及贫血分别占45.7％、21.0％和84.8％,而LMCI组则为26.6％(P<0.05)、8.9％(P<0.05)和41.7％(P<0.001)。ALL组脾肿大占54.3％而LMCL组占35.4％(P<0.05)。LMCL组纵隔阴影增宽的发生率(48.1％)明显高于ALL组(2.5％)(P<0.001),而且LMCL组31.6％的病人合并有上腔静脉综合征,骨髓受累的程度LMCL组也低于ALL组。据此,两病可资鉴别诊断。     

硼替佐米调控内质网应激诱导人急性T淋巴细胞白血病细胞株凋亡的机制探讨

目的:探讨硼替佐米对人急性T淋巴细胞白血病（T cell acute lymphoblastic leukemia，T-ALL）细胞株Molt-4细胞凋亡的影响。方法:硼替佐米（0、100、200和400 nmol/L）处理人急性T淋巴细胞白血病细胞株Molt-4细胞后，运用MTT法测定Molt-4细胞活力；使用Hoechst 33258染色法观察凋亡细胞形态；采用荧光定量PCR法测定Bax以及Bip mRNA水平；运用Western blot法测定Bax以及Bip蛋白水平。结果:100、200和400 nmol/L的硼替佐米处理Molt-4细胞24 h后，可浓度依赖性地降低细胞活力。100、200和400 nmol/L的硼替佐米作用细胞24 h后，Molt-4细胞核发生固缩或裂解。硼替佐米（100、200和400 nmol/L）处理细胞24 h后，Molt-4细胞的Bax mRNA和蛋白表达水平明显增加且可显著上调Bip mRNA和蛋白表达水平。结论:硼替佐米可诱导人急性T淋巴细胞白血病细胞株Molt-4细胞凋亡，作用机制可能与它调控内质网应激有关。     

Monensin-mediated growth inhibition in acute myelogenous leukemia cells via cell cycle arrest and apoptosis

Monensin, an Na(+) ionophore, regulates many cellular functions including apoptosis. However, there has been no report about the antitumoral effect of monensin on acute myelogenous leukemia (AML). Here, we investigated the antiproliferative effect of monensin on AML cells in vitro and in vivo. Monensin efficiently inhibited the proliferation of all of 10 AML cell lines, with IC(50) of about 0.5 microM. DNA flow cytometric analysis indicated that monensin induced a G(1) and/or a G(2)-M phase arrest in these cell lines. To address the mechanism of the antiproliferative effect of monensin, we examined the effect of monensin on cell cycle-related proteins in HL-60 cells. The levels of CDK6, cyclin D1 and cyclin A were decreased. In addition, monensin not only increased the p27 level but also enhanced its binding with CDK2. Furthermore, the activities of CDK2- and CDK6-associated kinases reduced by monensin were associated with hypophosphorylation of Rb protein. Monensin also induced apoptosis in AML cells including HL-60 cells. The apoptotic process of HL-60 cells was associated with changes in Bax, caspase-3, caspase-8 and mitochondria transmembrane potential (Deltapsi(m)). In particular, monensin (i.p. at a dose of 8 mg/kg thrice weekly) significantly reduced the tumor size of BALB/c mice that were inoculated s.c. with its derived cell line, WEHI-3BD cells (69% growth inhibition relative to control group; p < 0.05). Tumors from monensin-treated mice exhibited increased apoptosis, and these tumor were immunohistochemically more stained with Bax, Fas and p53 antibodies than control tumors. In conclusion, this is the first report that monensin potently inhibits the proliferation of AML cells.     

成人早期前体T急性淋巴细胞白血病（ETP-ALL）与非ETP-ALL的临床特点对比

目的:对比分析成人早期前体T急性淋巴细胞白血病（ETP-ALL）与非早期前体T急性淋巴细胞白血病（non-ETP-ALL）的临床特点。方法:回顾性分析于我科系统诊治的成人T细胞急性淋巴细胞白血病（T-ALL）患者19例,其中ETP-ALL 6例,non-ETP-ALL 13例,对比两组患者临床基本状况、血液及骨髓检测结果、免疫分型结果及诱导治疗后缓解情况。结果:ETP-ALL组患者白细胞水平显著低于non-ETP-ALL组患者,血小板水平显著高于non-ETP-AL组患者,主要见于pro-T-ALL,首次诱导治疗后完全缓解或接近完全缓解（CR/CRi）率显著低于后者。结论:ETP-ALL患者具有较独特的临床特点,对常规诱导治疗反应差,有必要积极探索新的治疗方法和药物。     

Hsa-miR-204反义寡核苷酸对急性淋巴细胞白血病细胞的增殖抑制作用

目的:观察抑制hsa-miR-204表达对人急性淋巴细胞白血病细胞（MOLT-4）生长与凋亡的影响。方法:设计合成hsa-miR-204的反义核苷酸序列（AMO-miR-204）并用脂质体转染法将其转染MOLT-4细胞。Q-PCR检测hsa-miR-204的表达量。噻唑蓝（MTT）试验和平板克隆形成实验检测细胞增殖能力;流式细胞术检测细胞早期凋亡率。Transwell检测细胞侵袭能力。结果:AMO-miR-204可抑制hsa-miR-204的表达,以反义核酸浓度为0.6μmol/L时,下调最为明显（P<0.05）。MTT实验示AMO-miR-204的最佳转染抑制浓度为0.6μmol/L。AMO6组细胞平板克隆形成能力明显减弱［（29±8）%］,差异有统计学意义（P<0.05）。流式细胞术检测AMO6组细胞凋亡达(7.47%）。Transwell细胞侵袭能力实验示AMO6组细胞侵袭能力较其余两组减弱。结论:AMO-miR-204能有效抑制MOLT-4细胞的增殖,并促进其凋亡。hsa-miR-204有可能作为急性淋巴细胞白血病（acute lymphoblastic leukemia,ALL）基因治疗的靶基因,同时也为深入揭示ALL的发生和发展机制提供了实验依据。     

Methods of dendritic cell preparation for acute lymphoblastic leukemia immunotherapy in children

Cell immunotherapy through dendritic cells (DC) presents a hopeful strategy for the treatment of various tumors. The aim of our study was to find which progenitor cells are most suitable for the preparation of dendritic cells in acute lymphoblastic leukemia (ALL) in pediatric patients, whether blasts from bone marrow or dendritic cells generated from peripheral blood mononuclear cells taken at the time of remission after induction chemotherapy. DC generated from the BM blasts of patients with B-ALL and T-ALL (n=15) at the time of diagnosis expressed low levels of costimulatory molecules and CD markers typical for mature DC. In contrast, DC cultivated from peripheral mononuclear cells of patients (n=9) had comparable morphology and expression of costimulatory molecules to DC obtained from healthy individuals, which was even higher after tumor lysate pulsing. Autologous lymphocyte proliferation increased after DC blasts lysate pulsation and further after lymphocyte restimulation, showing evidence of induction of specific cytotoxic lymphocytes. When comparing both cell sources for the preparation of DC in patients with ALL, it appears that peripheral mononuclear cells obtained after chemotherapy are more suitable than bone marrow leukemic blasts due to similar morphology, phenotypic, and functional capacity to monocytes of healthy donors. Despite this, it is necessary to take into account individual variability when preparing DC-based vaccines. The final verification of the efficiency of immunotherapy against residual hematopoietic malignant cells in patients with ALL can only be obtained through a clinical study.     

PQJS380: A novel lead compound to induce apoptosis in acute lymphoblastic leukemia cells

Acute lymphoblastic leukemia (ALL) is a malignant disorder of lymphoid progenitor cells that are committed to the B- or the T-cell lineage. The pathogenesis of ALL is heterogeneous and may be at least in part caused by genetic alterations. Although the modern sequencing technologies make it possible to rapidly discover novel genetic and epigenetic alterations and molecular targets for therapeutic intervention for ALL, conventional chemotherapy is still the most important therapeutic approach. Relapses and high morbidity and mortality remain major challenges particularly in adult patients with ALL. Therefore, development of novel chemotherapeutic agents remains in demand for ALL patients. In the course of seeking novel agents against ALL, we screened a library of small molecules and identified that PQJS380, a S-(E)-4-([7S,10S]-4-ethyl-7-isopropyl-2,5,8,12-tetraoxo-9-oxa-3,6,13,18-tetraaza-bicycle[13,2,1] octadec-1-en-10-yl)but-3-enyl octanethioate, showed potent anti-leukemia activity. PQJS380 inhibited the proliferation with IC₅₀ values of 14.25 nM and 5 nM in REH and NALM-6 cells, respectively. PQJS380 had 10-fold higher molar potency than the front-line ALL drugs Ara-C and VP-16. The median IC₅₀ value for leukemia blast cells from 17 patients with ALL was 52 nM. PQJS380 induced G₁-phase arrest in REH cells, and S-phase in NALM-6 cells, respectively. Treatment of PQJS380 led to apoptosis in ALL cell lines (REH and NALM-6) and primary ALL cells. Our data supported that PQJS380 may be a promising lead compound for ALL treatment even though the precise targets remain to be elucidated.     

儿童与成人急性B淋巴细胞白血病免疫表型的差异分析

目的:对儿童和成人急性B淋巴细胞白血病(B-ALL)免疫表型存在的差异进行分析,探讨不同年龄段B-ALL分型特征和临床意义。方法:以260例儿童和127例成人B-ALL患者为研究对象,使用流式细胞术对患者初发时骨髓标本进行免疫表型检测,分析抗原表达情况。结果:在全部B-ALL患者中B系抗原阳性率高的抗原有CD19,CD22,CD79a,分别达到了100%,99.73%,99.19%;而成熟B系抗原CD20和cIgM阳性率为31.27%和21.29%,阳性率较低。 CD10的阳性率为94.88%,在成人组和儿童组中存在明显差异,儿童组明显高于成人组(P＜0.05)。造血干/祖细胞抗原CD34、HLA-DR、CD38、cTdT阳性率分别为76.82％、98.38％、98.92％和92.72%,其中儿童患者CD34明显低于成人患者(P＜0.05)。髓系相关抗原CD33、CD13和CD15的表达最常见,分别达20.49％、20.49％、7.01％,其中CD33和CD15在儿童组中阳性率明显低于成人组(P＜0.05)。结论:免疫分型对儿童与成人B-ALL的诊断和微小残留病检测方案选择具有重要意义。     

RNA interference-mediated silencing of NANOG leads to reduced proliferation and self-renewal,cell cycle arrest and apoptosis in T-cell acute lymphoblastic leukemia cells via the p53 signaling pathway

NANOG is critical for maintaining the self-renewal and proliferative properties of embryonic stem cells. Here we found that cultured T-cell acute lymphoblastic leukemia (T-ALL) cells, as well as human primary T-ALL cells, express a functional variant of NANOG. NANOG mRNA is derived predominantly from a retrogene locus termed NANOGP8. Furthermore, we showed that RNA interference-mediated NANOG knockdown inhibited cell proliferation, reduced self-renewal, promoted apoptosis and arrested the cell cycle through a p53-mediated pathway in leukemic cells. These findings demonstrate the oncogenic potential of this pluripotent gene in human T-ALL cells.