化疗药物体外诱导原代白血病细胞凋亡与临床疗效的关系

目的　研究化疗药物体外诱导原代急性白血病 (AL)细胞凋亡与临床疗效的关系。方法　以 2 0例初发AL患者为研究对象 ,DNA片段原位末端标记 (TUNEL)方法检测凋亡细胞。骨髓原始细胞减少指数 (MBDI)作为临床疗效判定指标之一。结果　原代AL细胞体外经化疗药物处理后TUNEL阳性细胞率与化疗后MBDI呈正相关 (r =0 5 86,P <0 0 1)。TUNEL阳性细胞率 >2 7 6%组 ,完全缓解 (CR)率明显高于TUNEL阳性细胞率 <2 7 6%组 [80 0 % ( 8/10 )对 30 0 % ( 3/10 ) ,P =0 0 3]。结论　体外AL细胞凋亡率可以作为其对化疗药物反应的指标之一 ,与MBDI有互补作用

The Relationships between Apoptosis of Primary Acute Leukemic Cells Induced by Chemotherapeutic Agents in Vitro and its Clinical Therapeutic Effect

Objective To elucidate the relationship between apoptosis in vitro induced by chemotherapeutic agents and its clinical significance in primary acute leukemia(AL).Methods 20 patients with AL were investigated.The apoptosis of leukemic cells was analyzed with the method of TUNEL (terminal deoxyribonucleotidyl transferase-mediated dUTP-biotin nick end labeling).Marrow blast decrease index (MBDI) was valued as an index of clinical chemotherapeutic effects.Results The rate of TUNEL-positive AL cells induced by chemotherapeutic agents in vitro was correlated closely with MBDI (r=0.586,P<0.01) in vivo.The complete remission (CR) rate in the group of TUNEL-positive rate>27.6% was significantly higher than that in the group of TUNEL-positive rate <27.6% [80.0%(8/10) vs 30.0%(3/10),P=0.03].Conclusion The detection of apoptosis in vitro may supply MBDI with each other in prognosing the clinical therapeutic effect.