Dai Qingkai, Liu Xiaojuan, Yang Hui, Guo Siqi, Wang Yuefang, Peng Luyun, Ye Lei, Chen Lan, Lai Chunqi, Chen Qi, Zhang Ge, Jiang Yongmei
Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Ren Min Nan Lu, 610041, Chengdu, Sichuan, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Disease and Birth Defects of Ministry of Education, China.
Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, No. 20, Section 3, Ren Min Nan Lu, 610041, Chengdu, Sichuan, China; Key Laboratory of Obstetric & Gynecologic and Pediatric Disease and Birth Defects of Ministry of Education, China.
Leuk Res. 2018 May;68:57-61. doi: 10.1016/j.leukres.2018.03.001. Epub 2018 Mar 2.
Detection of aberrant antigen expression in acute lymphoblastic leukemia (ALL) by flow cytometric is proposed for the quantification of minimal residual disease (MRD). There are few studies that investigate the stability of the antigen expression in children with B lineage ALL at the end of remission induction therapy and determine its prognostic impact. Between 2010 and 2015, 691 bone marrow specimens of childhood ALL were sent at diagnosis for immunophenotypic characterization, and follow-up samples for MRD were analyzed on day 33. Of these, 155 patients with MRD more than or equal to 0.01% were eligible for the study. Immunophenotypic studies were performed by multiparametric flow cytometry using four-colour monoclonal antibody combinations. Overall, 86 of 155 (55.5%) cases showed phenotype shifts at least one marker. CD19 was the most stable markers. By contrast, CD20 was significantly different between diagnosis and day 33 in nearly one third of the cases. Shifts of antigen expression was not significantly associated with EFS, RFS or OS (P > 0.05). Multivariate analysis showed that WBC and BCR-ABL have independent prognostic value in childhood ALL. Changes in antigen expressions were commonly occurred at the end of induction and not associated with prognostic value in patients whose MRD were positive on day 33.
通过流式细胞术检测急性淋巴细胞白血病（ALL）中异常抗原表达，旨在对微小残留病（MRD）进行定量分析。很少有研究探讨B系ALL患儿在诱导缓解治疗结束时抗原表达的稳定性，并确定其预后影响。2010年至2015年间，691例儿童ALL骨髓标本在诊断时送检进行免疫表型特征分析，第33天分析MRD的随访样本。其中，155例MRD大于或等于0.01%的患者符合研究条件。免疫表型研究采用四色单克隆抗体组合通过多参数流式细胞术进行。总体而言，155例中的86例（55.5%）病例至少有一个标志物出现表型改变。CD19是最稳定的标志物。相比之下，近三分之一的病例中CD20在诊断和第33天之间存在显著差异。抗原表达的改变与无事件生存期（EFS）、无复发生存期（RFS）或总生存期（OS）无显著相关性（P>0.05）。多变量分析显示，白细胞计数（WBC）和BCR-ABL在儿童ALL中具有独立的预后价值。抗原表达的变化通常发生在诱导结束时，且与第33天MRD呈阳性的患者的预后价值无关。
