Todd M B, Waldron J A, Jennings T A, Rome L S, Markowitz S D, Holford T R, Gardner J P, Wolak J P, Malech H L
Blood. 1987 Jul;70(1):122-31.
In order to determine whether antigenic patterns alter with disease progression and are thereby suggestive of impending blast crisis in chronic myelogenous leukemia, 50 bone marrow biopsy specimens from 32 patients were examined retrospectively using indirect immunoperoxidase labeling with three monoclonal antibodies that detect myeloid antigens. Monoclonal antibodies PMN13F6, PMN7C3, and PMN8C7 detect human neutrophil antigens that first appear at the myeloblast, promyelocyte, and metamyelocyte stages of differentiation, respectively, and persist throughout later differentiation. Percentages of antigen-positive bone marrow cells during the chronic phase were compared with percentages of antigen-positive cells at blast transformation, and time from bone marrow biopsy until blast crisis was correlated with the percentage of bone marrow cells expressing these antigens. Bone marrow biopsy samples from patients in the chronic phase who continue to remain clinically stable 4 to 106 months after biopsy expressed PMN13F6 antigen on 82% +/- 9% (mean +/- SD) of cells, PMN7C3 antigen on 62% +/- 14% of cells, and PMN8C7 on 68% +/- 14% of cells. Bone marrow biopsy specimens obtained from patients 1 or more years prior to blast transformation expressed PMN13F6 antigen on 81% +/- 12%, PMN7C3 antigen on 71% +/- 16%, and PMN8C7 on 64% +/- 16% of cells. Bone marrow biopsy samples obtained between 2 months and 1 year prior to blast crisis expressed PMN13F6 antigen on 68% +/- 15%, PMN7C3 on 51% +/- 17%, and PMN8C7 antigen on 46% +/- 18% of cells. Bone marrow biopsy specimens taken at the time of blast transformation expressed PMN13F6 antigen on 20% +/- 25%, PMN7C3 antigen on 19% +/- 25%, and PMN8C7 antigen on 13% +/- 25% of cells. The difference between the mean of antigen-positive cells from bone marrow biopsy samples obtained at the time of blast crisis was significant compared with the mean of positive cells from biopsy specimens obtained at all other phases of the disease (P less than .001 for all three antibodies). There was a positive correlation between loss of myeloid antigens and disease progression as determined by simple regression of log time and correlation analysis (PMN13F6, r = .6533, P less than .005; PMN7C8, r = .6304, P less than .005; PMN8C7, r = .5215, P less than .05). There was a negative correlation between percentage of immature cells and time to blastic crisis (r = -.6206, P less than .005).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定抗原模式是否随疾病进展而改变，从而提示慢性粒细胞白血病即将发生急变期，我们回顾性地检查了32例患者的50份骨髓活检标本，采用间接免疫过氧化物酶标记法，使用三种检测髓系抗原的单克隆抗体。单克隆抗体PMN13F6、PMN7C3和PMN8C7分别检测人类中性粒细胞抗原，这些抗原首先出现在原始粒细胞、早幼粒细胞和晚幼粒细胞分化阶段，并在随后的分化过程中持续存在。将慢性期抗原阳性骨髓细胞的百分比与急变期抗原阳性细胞的百分比进行比较，并将骨髓活检至急变期的时间与表达这些抗原的骨髓细胞百分比进行关联分析。活检后4至106个月仍临床稳定的慢性期患者的骨髓活检样本中，82%±9%（均值±标准差）的细胞表达PMN13F6抗原，62%±14%的细胞表达PMN7C3抗原，68%±14%的细胞表达PMN8C7抗原。急变前1年或更早时间获取的患者骨髓活检标本中，81%±12%的细胞表达PMN13F6抗原，71%±16%的细胞表达PMN7C3抗原，64%±16%的细胞表达PMN8C7抗原。急变前2个月至1年获取的骨髓活检样本中，68%±15%的细胞表达PMN13F6抗原，51%±17%的细胞表达PMN7C3抗原，46%±18%的细胞表达PMN8C7抗原。急变期获取的骨髓活检标本中，20%±25%的细胞表达PMN13F6抗原，19%±25%的细胞表达PMN7C3抗原，13%±25%的细胞表达PMN8C7抗原。与疾病所有其他阶段获取的活检标本中阳性细胞的均值相比，急变期获取的骨髓活检样本中抗原阳性细胞的均值差异具有显著性（三种抗体的P均小于0.001）。通过对数时间的简单回归和相关性分析确定，髓系抗原的丢失与疾病进展呈正相关（PMN13F6，r = 0.6533，P小于0.005；PMN7C8，r = 0.6304，P小于0.005；PMN8C7，r = 0.5215，P小于0.05）。未成熟细胞百分比与急变时间呈负相关（r = -0.6206，P小于0.005）。（摘要截短至250字）
