流式细胞术在检测急性早幼粒细胞白血病微量残存病中的应用

目的探讨流式细胞术检测急性早幼细胞白血病（APL,M3）微小残留病变（MRD）的临床意义。方法采用三色荧光标记单克隆抗体（CD15、CD13、CD11b、CD33、CD34、CD45）,通过流式细胞仪检测50例初诊时经形态学及流式免疫分型诊断为M3的白血病患者及其中治疗后达到完全缓解（CR）的20例骨髓标本,同时检测正常对照骨髓标本10例。结果对于初发M3,以CD45/SSC（侧向角散射）设门,96%M3白血病细胞群表达CD15^-、CD11b^-、CD13^＋、CD33^＋;经治疗达到CR者以CD45/SSC设门,通过检测MRD,在MRD阳性组中复发率为57.0%,明显高于MRD阴性组,差异有统计学意义。结论流式细胞术是一种快速、简单、有效地检测急性早幼粒细胞微量残存病的方法。

Application of flow cytometry for detection of the minimal residual disease in acute promyelocytic leukemia

Objective To study the clinical significance of monitoring minimal residual disease（MRD）in acute promyelocytic leukemia（APL,M3）by flow cytometry.Methods Three-color combinations of monoclonal antibodies（CD15,CD13,CD11b,CD33,CD34,CD45）were used to detect 50bone marrow specimens of patients with APL diagnosed by FAB and immunophenotype before therapy and to follow up 20bone marrow specimens after initial induction therapy.Meanwhile,ten bone marrow specimens from normal controls were detected.Results Ninety-Six percents of M3leukemia cells expressed CD15-,CD11b-,CD13＋and CD33＋before therapy at CD45/SSC gate;after initial induction therapy,the recurrence rate of MRD-positive group was 57.0%,significantly higher than that of the MRD-negative group,there were significant difference between the two groups.Conclusion Flow cytometry is a fast,simple and effective method to detect the minimal residual disease in cute promyelocytic leukemia.