Department of Pediatrics, Yokohama City University Hospital, 3-9 Fukuura Kanazawa-ku, Yokohama, Japan.
Int J Hematol. 2009 Oct;90(3):311-317. doi: 10.1007/s12185-009-0412-4. Epub 2009 Sep 2.
Infection is a major obstacle in cancer chemotherapy. Neutropenia has been considered to be the most important risk factor for severe infection; however, other factors, such as impaired neutrophil function, may be involved in susceptibility to infection in patients undergoing chemotherapy. In this study, we analyzed neutrophil function in children with acute lymphoblastic leukemia (ALL). Whole blood samples were obtained from 16 children with ALL at diagnosis, after induction chemotherapy, and after consolidation chemotherapy. Oxidative burst and phagocytic activity of neutrophils were analyzed by flow cytometry. Oxidative burst of neutrophils was impaired in ALL patients. The percentage of neutrophils with normal oxidative burst after PMA stimulation was 59.0 +/- 13.2 or 70.0 +/- 21.0% at diagnosis or after induction chemotherapy, respectively, which was significantly lower compared with 93.8 +/- 6.1% in healthy control subjects (P = 0.00004, or 0.002, respectively); however, this value was normal after consolidation chemotherapy. No significant differences were noted in phagocytic activity in children with ALL compared with healthy control subjects. Impaired oxidative burst of neutrophils may be one risk factor for infections in children with ALL, especially in the initial periods of treatment.
感染是癌症化疗的主要障碍。中性粒细胞减少被认为是严重感染的最重要危险因素；然而，其他因素，如中性粒细胞功能受损，可能与化疗患者易感染有关。在这项研究中，我们分析了急性淋巴细胞白血病（ALL）患儿的中性粒细胞功能。在诊断时、诱导化疗后和巩固化疗后，从 16 名 ALL 患儿中获得全血样本。通过流式细胞术分析中性粒细胞的氧化爆发和吞噬活性。ALL 患者的中性粒细胞氧化爆发受损。用 PMA 刺激后具有正常氧化爆发的中性粒细胞的百分比在诊断时或诱导化疗后分别为 59.0 +/- 13.2 或 70.0 +/- 21.0%，与健康对照组的 93.8 +/- 6.1%相比显著降低（P = 0.00004 或 0.002，分别）；然而，在巩固化疗后，该值正常。与健康对照组相比，ALL 患儿的吞噬活性无显著差异。中性粒细胞氧化爆发受损可能是 ALL 患儿感染的一个危险因素，尤其是在治疗的初始阶段。
