急性髓系白血病CD123表达及其与FLT3-ITD突变的临床意义

目的:探讨急性髓系白血病(AML)患者中CD123表达及其与FLT3-ITD突变同步检测的临床意义。方法:采用流式细胞仪检测32例AML患者CD123表达,聚合酶链反应(PCR)检测FLT3-ITD突变。结果:32例AML中24例CD123表达阳性,阳性率75.0%,对照组表达阴性。CD123+患者诱导化疗完全缓解(CR)率37.5%,低于CD123-患者(75.0%)(P<0.05)。CD123+患者18个月生存率20.8%,低于CD123-患者(62.5%)(P<0.05)。32例AML中有6例FLT3-ITD突变阳性,阳性率18.8%,其中4例伴有CD123表达阳性,均未获完全缓解,生存期6～8个月。结论:CD123可能作为诊断急性髓系白血病独立参考依据之一及评估预后指标。CD123表达阳性及FLT3-ITD突变同时存在的AML患者生存期更短,预后更差。FLT3-ITD突变阳性患者CD123表达阳性率增高,FLT3-ITD突变在CD123+白血病干细胞最终形成中的意义值得深入探讨。

Clinical significance of CD123 expression and FLT3-ITD mutation in acute myeloid leukemia

Objective:To investigate the clinical significance of CD123expression and its synchronous detection to FLT3-ITD in acute myeloid leukemia(AML).Methods:CD123expression was detected by flow cytometry and FLTITD mutation by polymerase chain reaction(PCR)in 32patiences with acute myeloid leukemia.Results:The 24cases had CD123positive expression in 32AML,the positive rate of CD123was 75.0%,but the control group was negative.The induction chemotherapy complete remission(CR)rate of CD123+patients and CD123-patients was 37.5% and 75.0%respectively,which has statistical significance(P<0.05).The 18months survival rate of CD123+patients was 20.8%,lower than that of CD123-patients(62.5%),which has statistical significance(P<0.05).The 6cases had FLT3-ITD mutation in 32AML,the positive rate was 18.8%.4cases had CD123+in 6patients with FLT3-ITD mutation,all these 4patients with CD123+and FLT3-ITD mutation could not achieve CR and the overall survival were within 6～8months.Conclusion:CD123+could be used as one of independent diagnosis references and prognostic indicator in AML.The paitent with CD123+and FLT3-ITD mutation should be shorter overall survival and poorer prognosis.The CD123positive expression rate became higher in patients with FLT3-ITD mutation,the function of FLT3-ITD mutation in the leukemia stem cell formation was worth of further research.