骨髓增生异常综合征中循环CD34(+)细胞的生物学意义

Biological implications of circulating CD34(+) cells in myelodysplastic syndromes.

作者信息

Marisavljevic D, Kraguljac-Kurtovic N

机构信息

Medical Center "Bezanijska kosa", Department of Hematology, Belgrade, Serbia.

出版信息

J BUON. 2010 Oct-Dec;15(4):753-7.

PMID:21229641

Abstract

PURPOSE

to evaluate the biological and clinical significance of circulating CD34(+) cells in patients with myelodysplastic syndromes (MDS).

METHODS

the relative count of CD34(+) cells in peripheral blood was evaluated by flow cytometry and the results were recorded on the total number of mononuclear cells (MNCs). CD34(+) status was correlated with the percentage of circulating and bone marrow blasts, cytogenetic studies, CFU-GM colony growth, overall survival and transformation to acute myeloid leukemia (AML).

RESULTS

the number of MNC positive for anti-CD34 monoclonal antibody in the healthy control group ranged from 0.00% to 0.73%. Therefore, the cutoff value for overexpression of CD34 antigen on peripheral blood MNC of MDS patients was ≥ 1% (CD34(+) cases). The mean number of circulating CD34(+) MNCs in 30 MDS patients was significantly higher than in the control group (p=0.009). The proportion of circulating CD34(+) MNCs did not correlate with the blast count in the peripheral blood (r=0.282, p=0.131), neither with the blast count in the bone marrow. In contrast, the proportion of circulating CD34(+) cells in MDS patients was significantly correlated with the proportion of bone marrow CD34(+) cells (r=0.461, p=0.035). The proportion of circulating CD34(+) cells did not correspond to the percentage of blast count in the bone marrow, neither with the presence of cytogenetic abnormalities or abnormal growth of GM-progenitors. The median actuarial survival of 19 patients with elevated proportion of circulating CD34(+) cells was 16 months, as compared to >57 months in 11 patients with CD34(+) cells within normal range (p=0.16). Five patients with elevated proportion of circulating CD34(+) cells progressed to AML, as compared to only one of CD34(-)negative (CD34(-)) cases.

CONCLUSION

the presence of circulating CD34(+) cells is a common finding in MDS, but no significant correlations with clinical and/or biological features of the disease have been found.

摘要

目的

评估骨髓增生异常综合征（MDS）患者循环CD34(+)细胞的生物学及临床意义。

方法

采用流式细胞术评估外周血中CD34(+)细胞的相对计数，并将结果记录于单核细胞（MNC）总数上。CD34(+)状态与循环及骨髓原始细胞百分比、细胞遗传学研究、CFU-GM集落生长、总生存期以及向急性髓系白血病（AML）的转化相关。

结果

健康对照组中抗CD34单克隆抗体阳性的MNC数量范围为0.00%至0.73%。因此，MDS患者外周血MNC上CD34抗原过表达的临界值为≥1%（CD34(+)病例）。30例MDS患者循环CD34(+)MNC的平均数量显著高于对照组（p = 0.009）。循环CD34(+)MNC的比例与外周血原始细胞计数无关（r = 0.282，p = 0.131），与骨髓原始细胞计数也无关。相反，MDS患者循环CD34(+)细胞的比例与骨髓CD34(+)细胞的比例显著相关（r = 0.461，p = 0.035）。循环CD34(+)细胞的比例与骨髓原始细胞计数百分比无关，与细胞遗传学异常的存在或GM祖细胞的异常生长也无关。19例循环CD34(+)细胞比例升高患者的中位精算生存期为16个月，而11例CD34(+)细胞在正常范围内患者的中位精算生存期>57个月（p = 0.16）。5例循环CD34(+)细胞比例升高的患者进展为AML，而CD34(-)阴性（CD34(-)）病例中只有1例进展为AML。