急性髓细胞白血病细胞CD34抗原表达的临床及生物学意义

为研究ＣＤ３４在急性髓细胞白血病（ＡＭＬ）中的临床及生物学意义，用流式细胞术检测了１０７例ＡＭＬＣＤ３４表达。结果显示４８．５％的患者ＣＤ３４阳性表达，Ｍ３（１５．８％）低于其他亚型（ｐ〈０．０５）。ＣＤ３４＾＋者肝脾肿大常见。ＣＤ３４表达在ｔ（８；２１）、正常核型及ｔ（１５；１７）组分别为７２．０％、４０?７％及１７．６％。ＣＤ３４＾＋者的完全缓解率（４１．９％）明显低于ＣＤ３４＾－者的５９．６     

c-Kit受体和CD34在急性髓细胞白血病的表达及其与化疗疗效关系的研究

目的:了解c—kit受体和CD_(34)在急性髓细胞白血病的表达,探讨其与化疗疗效的关系.方法:应用流式细胞仪,测定10例正常人和87例急性髓细胞白血病骨髓c-kit受体和CD34的表达.结果和结论:正常人骨髓c-kit受体和CD34表达率分别为0.5%和1.7%.以>20%细胞表达为阳性,患者c-kit受体和CD34阳性率分别为52%和37%.c-kit受体和CD34阳性病例缓解率较低,差异有显著性(P<0.01),c-kit受体及CD34共同表达者疗效尤差(P<0.05).     

白血病bcl-2,p170,CD34表达的临床意义及其相关性

目的：探讨和分析白血病ｂｃｌ－２,ｐ１７９０,ＣＤ３４表达的临床意义及相相关性。方法：Ｅ和ＡＢＣ免疫细胞化学法检测急性白血病和２３例慢性粒细胞白血病ｂｃｌ－２,Ｐ１７０,ＣＤ３４４的表达。结果：复发、难治急性白血病ｂｃｌ－２、ｐ１７０、ＣＤ３４的表达率明显高于初治急性白血病;ｂｃｌ－２,Ｐ１７０,ＣＤ３４高表达的急性白血病完全缓解率显著低于低于不表达或低表达者;加速／急变期的慢性粒细胞白血病（ＣＤ     

CD34阳性成人急性髓系白血病临床及生物学研究

检测了４０例成人初治急性髓系白血病细胞ＣＤ３４抗原的表达，并分析了ＣＤ３４表达与一般临床特征，其它免疫标志，。染色体异常及治疗效果的关系。结果显示，４０例ＡＭＬ中ＣＥ３４阳性表达１７例，占４２．５％，除Ｍ３无ＣＤ３４表达外，ＣＤ３４表达与ＦＡＢ亚型无关。     

白血病bcl—2,CD34表达的临床意义

目的 探讨白血病ｂｃｌ－２,ＣＤ４３表达的临床意义和相关民生。方法 用ＡＢＣ免疫细胞化学方法检测了７７例急性白血,２３例慢性粒细胞白血病ｂｃｌ－２,ＣＤ３４的表达。结果 复发／难治急性白血病ｂｃｌ－２,ＣＤ３４的表达高于初始者;慢粒白血病加速期／急变期组高于慢性期组,ｂｃｌ－２,ＣＤ３４高表达的急性白血病完全缓解率低,早期复发率高,ｂｃｌ－２与ＣＤ３４的表达呈轻度正相关（ｒ＝０．３６７,Ｐ〈０．０     

CD34抗原、bcl-2蛋白表达与急性髓性白血病化疗耐药

目的检测急性髓性白血病(AML)中CD34,bcl-2的表达,并评价其临床意义及CD34,bcl-2间可能存在的关系.方法免疫细胞化学APAAP法.结果CD34、bcl-2表达与AML外周血WBC数.骨髓原始细胞比例、CUF-L等临床特征无关;而继发性AMLCD34水平显著高于原发性AML患者(P＜0.05);但bcl-2水平在原发,继发AML中无差别.原发性AML中CD34水平与化疗疗效无关(P＞0.05);无论原发AML或AML中,bcl-2表达均与化疗耐药有关.结论CD34并非一个能独立耐药相关的因素,而bcl-2可以独立决定化疗反应;CD34和bcl-2无相关性.     

急性髓系白血病的bcl-2基因表达及其临床意义

目的：探讨bcl—2基因在急性髓系白血病(AML)中的表达与预后的关系。方法：应用链亲和素-胶体金原位杂交(ISH—SAG)法检测57例AML患者单个核细胞的bcl—2基因表达水平。结果：57例AML患者不同程度表达bcl—2基因，范围从0—98％，其中初治组的阳性率为46．2％(24／52)，缓解组的阳性率为40．7％(11／27)，难治复发组的阳性率为100％(15／15)；难治复发组与初治组及缓解组之间差异均具有显著性(P＜0．01)，AML各亚型之间表达无显著性差异(P＞0．05)；疗效分析发现bcl-2基因表达与临床缓解密切相关，阴性组缓解率(76．2％)显著高于阳性组(42．1％)(P＜0．05)。结论：bcl—2基因过度表达对AML的预后有重要关系，可作为判断预后和合理制定治疗方案的重要依据。     

白血病bcl-2、CD_(34)表达的临床意义

目的探讨白血病bcl-2、CD34表达的临床意义和相关性。方法用ABC免疫细胞化学方法检测77例急性白血、23例慢性粒细胞白血病bcl-2、CD34的表达。结果复发／难治急性白血病bcl-2、CD34的表达高于初治者;慢粒白血病加速期／急变期组高于慢性期组。bcl－2、CD34高表达的急性白血病完全缓解率低,早期复发率高.bcl-2与CD34的表达呈轻度正相关（r＝0．367,P＜0．001）。结论bcl－2、CD34高表述可能与急性白血病预后不良有关。bcl－2的表达增高可能是CD34高表达的急性白血病预后不良的原因之一。     

High expression of bcl-2 mRNA as a determinant of poor prognosis in acute myeloid leukemia

Background: The bcl-2 oncoprotein is suggested to be directly involved in the emergence of drug resistance by disrupting or delaying the apoptotic program and promoting tumor survival.Patients and methods: In order to define the clinical relevance of the bcl-2 mRNA expression in acute myeloid leukemia (AML) and its correlation to therapy outcome and prognosis, we analyzed 219 AML bone marrow (BM) samples, including 119 patients with de novo AML at presentation, 37 with AML following myelodysplastic syndrome (MDS), as well as 42 BM samples of AML in relapse and 21 in complete remission (CR) using RT-PCR. For performing quantitative measurements of bcl-2 mRNA, we developed a quantitative RT-PCR.Results: Bcl-2 mRNA was detectable in 133 of 156 (84%) patients at diagnosis and 40 of 42 (95%) at relapse. AML patients with high bcl-2 mRNA expression achieved lower CR rates than those with no or low expression. Concerning the long-term outcome, the overall (OS) and disease-free survival (DFS) was significantly worse in AML patients with high expression levels of bcl-2 mRNA. The three-year OS for all newly diagnosed AML patients was 49% and 10% (P = 0.028), respectively, and 71% and 15% (P = 0.0004) for patients <60 years. Comparable significant differences were observed for the DFS.In AML following MDS and patients >60 years, the bcl-2 expression was not associated with remission rate or survival.Conclusions: The expression of bcl-2 mRNA may serve as a prognostic factor predicting remission outcome and long-term prognosis in AML.     

急性髓性白血病bcl—2mRNA表达与抗癌药敏感性及临床疗效关系

目的：探讨急性髓性白血病bcl-2 mRNA表达与抗癌药物敏感性及临床疗效的关系。方法：用半定量RT－PCR方法检测29例急性髓性白血病bcl-2 mRNA表达，并用MTT法测定10种抗癌药的抑制率，以正常健康人bcl-2mRNA表达水平均值作为分界点，分成阴性组和阳性组，统计比较抗癌药在两组中的抑制率并观察临床疗效。结果：bcl-2mRNA表达阴性组抗癌药抑制率大于阳性组，其中氮芥，阿糖胞苷，鬼臼乙叉甙存在显差异（P＜0．05），甲氨蝶呤，环磷酰胺存在极显差异（P＜0．01）。bcl-2mRNA阴性组化疗缓解率高于阳性组，两组具统计学意义（P＜0．05）。结论:bcl-2 mRNA在急性髓性白血病表达可作为一种多药抵抗分子来预测体外药物的敏感性,bcl-2mRNA低表达化疗疗效好。     

In vivo use of all-trans retinoic acid prior to induction chemotherapy improves complete remission rate and increases rhodamine 123 uptake in patients with de novo acute myeloid leukemia

All-trans retinoic acid (ATRA) is used in the treatment of acute promyelocytic leukemia. Because ATRA has effects (increase in apoptosis, suppression of bcl-2), it has also been used for the treatment of other French-American-British (FAB) subtypes of acute myelogenous leukemia (AML). To find out the in vivo and in vitro effects of ATRA in AML, we analyzed 37 patients with de novo AML. Twenty-seven patients received ATRA before remission-induction (RI) treatment (ATRA group). Results were compared to a control group (10 patients) that received induction without ATRA during the same time period. Bone marrow or peripheral blood samples were collected from all patients on d 0 and 4. The immunphenotype, myeloperoxidase (MPO), reaction and the efflux uptake of rhodamine 123 (Rh123) were analyzed on myeloblasts in these samples. In the myeloblasts from patients treated with ATRA, the uptake of Rh123 was increased significantly (p=0.026) from d 0 to d 4, and all other parameters remained unaltered. ATRA administration increased the complete remission (CR) rate (88%, 22/25 vs 55%, 5/9) significantly (p=0.042). Logistic regression analysis revealed that ATRA administration was the important factor in CR, among other potential factors including age, white blood count, bcl-2 expression, and the uptake and efflux of Rh123 (p=0.05). Estimated disease-free survival and overall survival were similar between these two groups (43% vs 37.5% and 51.2% vs 37.5%, respectively). In conclusion, ATRA treatment prior to RI treatment may improve the CR rate in patients with de novo AML, which seems to be related to its beneficial effect on multidrug resistance.     

白血病bcl-2,pI7O,CD_(34)表达的临床意义及其相关性

目的 :探讨和分析白血病bcl- 2 ,p170 ,CD34 表达的临床意义及其相关性。方法 :用ABC免疫细胞化学法检测 77例急性白血病和 2 3例慢性粒细胞白血病bcl- 2 ,p170 ,CD34 的表达。结果 :复发、难治急性白血病bcl- 2 ,p170 ,CD34 的表达率明显高于初治急性白血病 ;bcl- 2 ,p170 ,CD34 高表达的急性白血病完全缓解率显著低于不表达或低表达者 ;加速 /急变期的慢性粒细胞白血病CD34 表达高于慢性期 ;bcl- 2高表达的阳性符合率为 90 .9% ,略高于p170或CD34 ;白血病bcl- 2 ,p170的表达有轻度正相关性 (r =0 .3 86,P <0 .0 0 1)。 结论 :bcl- 2为较敏感的临床预测指标 ,联合检测bcl- 2 ,p170 ,CD34 可能提高单一指标的预测价值。CD34 可能是CML病程进展的指标。而不同多药耐药机制可能有一定的联系     

吉妥珠单抗在CD33阳性急性髓系白血病中的研究进展

急性髓系白血病（acute myeloid leukemia,AML）是一种异质性髓系恶性肿瘤,目前化疗联合造血干细胞移植是主要治疗方法,但是总体预后较差。吉妥珠单抗（gemtuzumab ozogamicin,GO）是一种人源化抗CD33单抗与卡奇霉素结合的抗体偶联药物,主要用于治疗CD33阳性AML。虽然研究发现GO可以改善CD33阳性AML患者的预后,但是仍有部分AML患者并未获益。GO治疗AML的疗效主要与CD33表达及单核苷酸多态性（single nucleotide polymorphism,SNP）、ATP 结合盒亚家族B成员1（ATP-binding cassette subfamily B member 1,ABCB1）基因及SNP、特异的分子生物学和细胞遗传学等因素有关。本文就GO对AML疗效影响因素的研究进展进行综述。     

The clinical significance of soluble CD86 levels in patients with acute myeloid leukemia and myelodysplastic syndrome

BACKGROUND: Levels of the soluble form of CD86 (sCD86) are elevated in a proportion of patients with leukemia. Although it is a potential modulator of antitumor responses, the significance of sCD86 in patients with hematologic malignancies is unknown. METHODS: The authors evaluated sCD86 levels by enzyme-linked immunosorbent assay in patients with acute myeloid leukemia (AML) (n = 57 patients) and patients with myelodysplastic syndrome (MDS) (n = 40 patients) and analyzed the relation between sCD86 levels and various clinical parameters. RESULTS: Levels of sCD86 were elevated (> 2.32 ng/mL) relative to normal donors (0.22-2.32 ng/mL; n = 51 patients) in 25% of patients with AML and in 27% of patients with MDS. Patients with AML who had elevated sCD86 levels had significantly lower complete remission (CR) rates compared with patients with AML who had normal sCD86 levels. In multivariate analysis using sCD86 as a continuous variable and including the interaction of age and sCD86 as a variable, sCD86 was a significant prognostic factor (P = 0.014) independent of cytogenetics. Further analysis demonstrated that, in patients with AML age 60 years and younger, but not in patients older than 60 years, elevated sCD86 levels were associated with significantly shorter survival (P = 0.04). There was no correlation between sCD86 levels and CR rates or survival in patients with MDS. CONCLUSIONS: The presence in patients with AML of elevated levels of circulating sCD86 were associated with lower CR rates and poor survival. The prognostic significance of sCD86 was independent of cytogenetics but was modulated by age, in that it was independently significant only in younger patients. The results suggest that sCD86 may play a role in modulating immune responses associated with the progression of AML.     

COX-2在急性髓细胞白血病中的表达和临床意义的初步研究

目的 探讨环氧化酶2（COX-2）基因在急性髓细胞白血病（AML）中的表达和意义及其对预后的影响。方法 采用Real time PCR检测AML患者中COX-2 mRNA的表达水平,分析COX-2表达水平与AML临床病理特征和预后的关系。采用Kaplan-Meier 法分析COX-2表达与总生存期（OS）的关系。结果 38例AML患者COX-2 mRNA相对表达量的均值为4.77±2.21,其中20例患者为COX 2高表达（8.33±1.96）,18例患者为低表达（1.89±1.04）。COX-2表达与初诊白细胞计数和初次治疗反应有关,与性别和年龄无关。COX-2高表达者的中位OS为16.2个月,低于低表达者的25.6个月（P=0.041）。结论 COX-2表达水平与AML患者的生存有关,其高表达可能是AML的不良预后因素。