慢性粒细胞白血病患者骨髓部分细胞因子的表达及意义

目的探讨慢性粒细胞白血病(CML)患者不同时期骨髓白细胞介素(IL)-1β、IL-2、IL-4、IL-6、IL-10及干扰素-γ(INF-γ)表达的变化。方法应用流式细胞仪分析30例CML慢性期(CML-CP)、21例加速期(CML-AP)、15例急变期(CMLBP),经治疗后缓解患者42例、未缓解患者7例的骨髓液中IL-1β、IL-2、IL-4、IL-6、IL-10及INF-γ表达水平,并与对照组比较。结果CML各组患者INF-γ、IL-2水平均低于对照组(P0.05),IL-1β、IL-4、IL-6、IL-10均高于对照组(P0.05)。随着病情进展,INF-γ、IL-2水平逐渐降低,即CML-BPCML-APCML-CP,且组间比较差异有统计学意义(P0.05);IL-1β、IL-4、IL-6、IL-10逐渐增高,即CML-BPCML-APCML-CP,组间比较差异有统计学意义(P0.05)。患者经治疗完全缓解后,INF-γ、IL-2有所回升,但仍低于对照组(P0.01),IL-1β、IL-4、IL-6、IL-10有所降低,同样也高于CML-CP(P0.05);未缓解组IL-1β、IL-4、IL-6、IL-10及IL-2、INF-γ与急变期相比差异无统计学意义(P0.05)。结论在CML患者骨髓微环境中细胞因子水平的变化对CML的发生、发展及与预后评估有一定的意义;检测CML骨髓IL-1β、IL-2、IL-6、IL-10及INF-γ水平有望为CML患者免疫治疗及预后判断提供新的思路和理论依据。

Expression of partial cytokines in bone marrow of chronic myeloid leukemia patients and its significance

Objective To investigate the changes of IL‐1β,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 and INF‐γexpressions in bone marrow of chro‐nic myeloid leukemia(CML)patients .Methods The IL‐1β,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 and INF‐γexpression levels were detected by u‐sing flow cytometry in 30 cases of CML chronic phase(CML‐CP) ,21 cases of CML accelerated phase(CML‐AP) ,15 cases of CML blastic phase(CML‐BP) ,42 cases of CML remission after treatment and 7 cases of non‐remission .Then the detection results were compared with those in the control group .Results The expression levels of INF‐γ and IL‐2 in each CML groups were lower than those in the control group(P<0 .05) ,while the expression levels of IL‐1β,IL‐4 ,IL‐6 and IL‐10 were higher than those in the con‐trol group(P<0 .05) .With the disease condition progression ,the INF‐γand IL‐2 levels were gradually decreased ,i .e .,CML‐BPCML‐AP> CML‐CP ,the difference among groups had statistical significance (P<0 .05) .After complete remission by treatment ,the INF‐γand IL‐2 levels were risen to some extent ,but which were still lower than those in the control group(P<0 .01) ,the expression levels of IL‐1β,IL‐4 ,IL‐6 and IL‐10 were decreased to some extent ,but likewise were higher than those in CML‐CP(P< 0 .05);the levels of IL‐1β,IL‐4 ,IL‐6 ,IL‐10 ,IL‐2 and INF‐γ had no statistical difference between the non‐remission group and CML‐BP group(P>0 .05) .Conclusion The changes of serum cytokines in bone marrow microenvironment of CMLpatients have certain significance to the occurrence ,development and prognosis of CML ;the de‐tection of IL‐1β,IL‐2 ,IL‐4 ,IL‐6 ,IL‐10 and INF‐γlevels in bone marrow is hopeful to provide new ideas and theoretical basis for im‐mune therapy and prognosis judgment of CML patients .