t(8;21)急性髓系白血病患者缓解时ALDH活性对复发的预测意义

目的:探讨t(8;21)急性髓系白血病(AML)患者治疗前后骨髓乙醛脱氢酶高活性(ALDH+)细胞比例对复发的预测意义.方法:收集2015年4月至2016年6月北京大学人民医院收治的23例t(8;21)AML患者初诊及完全缓解(CR)时的骨髓标本,采用流式细胞术检测ALDH活性,分析其与复发的关系.结果:全部患者中位随...

The Predict Significance of ALDH Activity to the Relapse of t(8;21)Acute Myeloid Leukemia Patients at Complete Remission

Objective;To investigate the predict significance of the high aldehyde dehydrogenase activity(ALDH^+)propitiation to the relapse of t(8;21)acute myeloid leukemia(AML)patients before and after treatment.Methods;Bone marrow samples of 23 t(8;21)AML patients diagnosis and achieved complete remission in our hospital from April 2015 to June 2016 were collected,then flow cytometry method was used to detect the activity of ALDH,relationship between it and relapse was analyzed.Results;All the patients were followed up for a median of 32(2-52)months.The median percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells among nucleated cells were 2.7(0.36-35.7)%and 0.017(0.0013-0.62)%at diagnosis,respectively.Among the bone marrow samples in patients achieved CR,the median percentage of CD34^+CD38^-cells was 0.035(0.0064-0.66)%,and it was significantly decreased as compared with the percentage at diagnosis(P<0.001);The median percentage of CD34^+CD38^-ALDH^+cells was 0.014(0.0019-0.24)%,and it showed no different as compared with the percentage at diagnosis(P=0.45).Survival analysis showed that patients with higher percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells at diagnosis tended to the lower 3-year relapse-free survival(RFS)(P=0.27 and 0.21).Furthermore,patients with higher percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells when achieved CR had a significant lower 3-year RFS rates(P=0.010 and 0.0044)as compared with those with lower percentage of CD34^+CD38^-and CD34^+CD38^-ALDH^+cells.Multivariate analysis showed that higher percentage of CD34^+CD38^-ALDH^+cells when achieved CR was an independent factor affecting RFS of the patients.Conclusion;The percentage of CD34^+CD38^-ALDH^+cells at CR in t(8;21)AML patients could predicts relapse,and had more profound predictive significance for relapse than the percentage of CD34^+CD38^-cells.