Nakamura K, Ogata K, An E, Dan K
Third Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.
Br J Haematol. 2000 Mar;108(4):710-6. doi: 10.1046/j.1365-2141.2000.01906.x.
There is little information available regarding immunophenotypic monitoring of minimal residual disease (MRD) in acute myeloid leukaemia (AML). We investigated leukaemic cells co-expressing CD15 and CD117 (CD15+CD117+) in 72 adult AML cases at diagnosis. In 22 cases (31%) with various AML subtypes, more than 5% of leukaemic cells showed the CD15+CD117+ phenotype (range 5.22-55.48%). These 22 cases were younger and had a higher complete remission (CR) rate than the other AML cases, but the CD15+CD117+ cell percentage at diagnosis showed no correlation with the CR duration among the 72 cases. The CD15+CD117+ cell percentage showed a range of 0.00-0.08% in bone marrow cells from 10 haematologically normal subjects. We also investigated CD15+CD117+ cells in sequential bone marrow samples from 17 AML patients who achieved CR and who had had more than 5% CD15+CD117+ leukaemic cells at diagnosis. Because the CD15+CD117+ cell percentage varied among these AML cases, we calculated the percentage of MRD ¿MRD% = [CD15+CD117+ cells (%) in each sequential marrow sample] / [CD15+CD117+ cells (%) at diagnosis of the corresponding case] x 100¿. A high MRD% after 10 months of CR was significantly associated with a short CR duration (P = 0.0004), whereas continuation of a well-reduced MRD% was associated with a long CR duration. The leukaemic cells conserved the CD15+CD117+ phenotype in all of the eight cases who relapsed. Flow cytometric monitoring of CD15+CD117+ cells is simple and can be applied to a substantial fraction of AML cases. This monitoring may be useful for predicting relapse of adult AML.
关于急性髓系白血病（AML）微小残留病（MRD）的免疫表型监测，目前可用信息较少。我们在诊断时调查了72例成年AML病例中共同表达CD15和CD117（CD15+CD117+）的白血病细胞。在22例（31%）不同AML亚型的病例中，超过5%的白血病细胞表现出CD15+CD117+表型（范围为5.22 - 55.48%）。这22例患者比其他AML病例更年轻，完全缓解（CR）率更高，但在这72例病例中，诊断时CD15+CD117+细胞百分比与CR持续时间无关。10名血液学正常受试者的骨髓细胞中，CD15+CD117+细胞百分比范围为0.00 - 0.08%。我们还在17例达到CR且诊断时CD15+CD117+白血病细胞超过5%的AML患者的连续骨髓样本中调查了CD15+CD117+细胞。由于这些AML病例中CD15+CD117+细胞百分比各不相同，我们计算了MRD百分比（MRD% = [每个连续骨髓样本中CD15+CD117+细胞（%）] / [相应病例诊断时CD15+CD117+细胞（%）]×100）。CR 10个月后高MRD%与短CR持续时间显著相关（P = 0.0004），而持续保持低MRD%则与长CR持续时间相关。在所有8例复发的病例中，白血病细胞均保留了CD15+CD117+表型。对CD15+CD117+细胞进行流式细胞术监测简单易行，可应用于相当一部分AML病例。这种监测可能有助于预测成年AML的复发。
