Starý J, Sokol L, Hausner P, Hrodek O, Sedmihorská J, Volejníková J, Vlachynský M
II. dĕtská klinika fakultní nemocnice Motol, Praha.
Cas Lek Cesk. 1992 Jun 19;131(12):364-7.
The authors examined, using the method of flow cytometry, 56 children with acute lymphoblastic leukaemia. Leukaemic cells of the bone marrow aspirate and peripheral blood were examined on a FACS 440 apparatus for establishment of the diagnosis before treatment was initiated. Individual immunological subtypes were differentiated by means of a panel of monoclonal antibodies. 80.5% of acute lymphoblastic leukaemias originated from different developmental stages of B cells, 12.5% were formed by leukaemias from T cells and 7% were non-differentiated leukaemias. The mean follow-up period in the group was 33 months. According to the therapeutic results children with leukaemia ensuing from precursors of B cells had a more favourable prognosis than children with T leukaemia and children with non-differentiated leukaemia. Quantitative examination of nuclear DNA of leukaemic cells revealed in 55% of the patients of the group aneuploidy with clear predominance of hyperdiploidy, 45% of the patients suffered from diploidy. The least number of relapses was recorded in the investigation period in children with hyperploid acute lymphoblastic leukaemia. The proliferating activity of leukaemic blasts was expressed by the number of cells in the S + G2M stage of the cellular cycle and was higher in the bone marrow than in peripheral blood but did not differ in individual immunological subtypes or in diploid leukaemias. The authors were not able to prove its prognostic importance. Flow cytometry is a rapid and sensitive diagnostic method which makes it possible to characterize more satisfactorily the heterogeneous group of acute lymphoblastic leukaemias.
作者采用流式细胞术方法对56例急性淋巴细胞白血病患儿进行了检查。在启动治疗前,对骨髓穿刺液和外周血中的白血病细胞在FACS 440仪器上进行检查以确立诊断。通过一组单克隆抗体区分各个免疫亚型。80.5%的急性淋巴细胞白血病起源于B细胞的不同发育阶段,12.5%由T细胞白血病构成,7%为未分化白血病。该组的平均随访期为33个月。根据治疗结果,B细胞前体引发的白血病患儿的预后比T细胞白血病患儿和未分化白血病患儿更有利。白血病细胞核DNA的定量检查显示,该组55%的患者存在非整倍体,超二倍体明显占优势,45%的患者为二倍体。在研究期间,超倍体急性淋巴细胞白血病患儿的复发次数最少。白血病母细胞的增殖活性通过细胞周期S + G2M期的细胞数量来表示,在骨髓中高于外周血,但在各个免疫亚型或二倍体白血病中并无差异。作者未能证明其预后重要性。流式细胞术是一种快速且灵敏的诊断方法,它能够更令人满意地对急性淋巴细胞白血病的异质性群体进行特征描述。