Holmes P J, Peiper S C, Uppal G K, Gong J Z, Wang Z-X, Bajaj R
The Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Int J Lab Hematol. 2016 Oct;38(5):483-9. doi: 10.1111/ijlh.12513. Epub 2016 Aug 27.
Chronic lymphocytic leukaemia (CLL) is the most prevalent leukaemia in the Western Hemisphere. Cytogenetic abnormalities in CLL are used for diagnosis, prognosis and treatment. However, detecting these is difficult because mature B cells do not readily divide in culture. Here, we present data on two mitogen cocktails: CpG-oligonucleotide DSP30/Interleukin-2 (IL-2) and DSP30/IL-2 in combination with 12-O-tetradecanoylphorbol-13-acetate (TPA).
We analysed 165 cases of CLL with FISH and cytogenetics from January 2011 to June 2013. In 2011, three cultures were set-up: unstimulated, DSP30/IL-2-stimulated and TPA-stimulated. In 2012-2013, two cultures were set-up: unstimulated and stimulated with TPA/DSP30/IL-2.
In 2011, FISH had a detection rate of 91% and cytogenetics using DSP30/IL2 had a detection rate of 91% (n = 22). In 2012-2013, FISH had a detection rate of 79% and cytogenetics using TPA/DSP30/IL-2 had a detection rate of 98% (n = 40). The percentage of cases with normal FISH but abnormal cytogenetics increased from 9% in 2011 to 21% in 2012-2013. The TPA/DSP30/IL-2 cultures in 2012-2013 detected more novel abnormalities (n = 5) as compared to DSP30/IL-2 alone (n = 3).
TPA/DSP30/IL2 was as good as or better than DSP30/IL2 alone. TPA/DSP30/IL-2 offers a high detection rate for CLL abnormalities with a single stimulated culture and may increase detection of clinically significant abnormalities.
慢性淋巴细胞白血病(CLL)是西半球最常见的白血病。CLL中的细胞遗传学异常用于诊断、预后评估和治疗。然而,检测这些异常很困难,因为成熟B细胞在培养中不易分裂。在此,我们展示了两种促有丝分裂原混合物的数据:CpG寡核苷酸DSP30/白细胞介素-2(IL-2)以及DSP30/IL-2与十四烷酰佛波醇乙酯(TPA)联合使用的情况。
我们对2011年1月至2013年6月期间的165例CLL病例进行了荧光原位杂交(FISH)和细胞遗传学分析。2011年,设置了三种培养方式:未刺激、DSP30/IL-2刺激和TPA刺激。2012 - 2013年,设置了两种培养方式:未刺激和TPA/DSP30/IL-2刺激。
2011年,FISH的检测率为91%,使用DSP30/IL2的细胞遗传学检测率为91%(n = 22)。2012 - 2013年,FISH的检测率为79%,使用TPA/DSP30/IL-2的细胞遗传学检测率为98%(n = 40)。FISH结果正常但细胞遗传学异常的病例百分比从2011年的9%增加到2012 - 2013年的21%。与单独使用DSP30/IL-2(n = 3)相比,2012 - 2013年的TPA/DSP30/IL-2培养检测到更多新的异常(n = 5)。
TPA/DSP30/IL2与单独使用DSP30/IL2效果相当或更好。TPA/DSP30/IL-2通过单一刺激培养对CLL异常具有较高的检测率,并且可能增加对具有临床意义的异常的检测。