急性髓系白血病早期反应评估中骨髓活检的CD34免疫组织化学
CD34 immunohistochemistry in bone marrow biopsies for early response assessment in acute myeloid leukemia.
作者信息
Jain S, Mahapatra M, Pati H P
机构信息
Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
出版信息
Int J Lab Hematol. 2015 Dec;37(6):746-51. doi: 10.1111/ijlh.12406. Epub 2015 Aug 6.
INTRODUCTION
Acute myeloid leukemia is a heterogenous disease with respect to prognosis. Early response assessment has an established role as predictor of remission rate, and overall and disease-free survival. Assessment of blast percentage on bone marrow aspirate smears at this stage has its own limitations.
MATERIALS AND METHOD
In this study, a total of 100 AML cases that were positive for CD34 at the time of diagnosis were included in the study. Blast percentage obtained in bone marrow aspirate smears by morphology was compared with that obtained in bone marrow biopsy using CD34 immunohistochemistry.
RESULTS
Bone marrow aspirate and biopsy were discordant in 19% of the cases. In 15% of the cases, bone marrow aspirate blast count was ≤ 5% and bone marrow biopsy blast percentage was >5%.
CONCLUSION
Early response assessment plays an important role in management of acute myeloid leukemia. In patients with CD34-positive blasts, the CD34 IHC can improve the detection of residual blasts on Day 14 bone marrow biopsy in comparison with morphological assessment of blast percentage in bone marrow aspirate.
引言
急性髓系白血病在预后方面是一种异质性疾病。早期反应评估作为缓解率、总生存率和无病生存率的预测指标已确立其作用。在此阶段，通过骨髓穿刺涂片评估原始细胞百分比有其自身的局限性。
材料与方法
本研究纳入了共100例诊断时CD34呈阳性的急性髓系白血病病例。将通过形态学在骨髓穿刺涂片中获得的原始细胞百分比与使用CD34免疫组织化学在骨髓活检中获得的结果进行比较。
结果
19%的病例骨髓穿刺和活检结果不一致。在15%的病例中，骨髓穿刺原始细胞计数≤5%，而骨髓活检原始细胞百分比>5%。
结论
早期反应评估在急性髓系白血病的管理中起着重要作用。对于CD34阳性原始细胞的患者，与通过形态学评估骨髓穿刺涂片的原始细胞百分比相比，CD34免疫组织化学可提高在第14天骨髓活检时对残留原始细胞的检测。
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