[醛脱氢酶活性对完全缓解的t(8;21)急性髓系白血病患者复发的预测意义]

[The Predict Significance of ALDH Activity to the Relapse of t(8;21) Acute Myeloid Leukemia Patients at Complete Remission].

作者信息

Yang Lu, Dao Feng-Ting, Wang Ya-Zhe, Liu Yan-Rong, Jiang Hao, Jiang Qian, Liu Kai-Yan, Qin Ya-Zhen

机构信息

Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China.

Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2021 Feb;29(1):43-48. doi: 10.19746/j.cnki.issn.1009-2137.2021.01.007.

DOI:10.19746/j.cnki.issn.1009-2137.2021.01.007

PMID:33554795

Abstract

OBJECTIVE

To investigate the predict significance of the high aldehyde dehydrogenase activity (ALDH) propitiation to the relapse of t(8;21) acute myeloid leukemia(AML) patients before and after treatment.

METHODS

Bone marrow samples of 23 t(8;21) AML patients diagnosis and achieved complete remission in our hospital from April 2015 to June 2016 were collected, then flow cytometry method was used to detect the activity of ALDH, relationship between it and relapse was analyzed.

RESULTS

All the patients were followed up for a median of 32 (2-52) months. The median percentage of CD34CD38 and CD34CD38ALDH cells among nucleated cells were 2.7 (0.36-35.7)% and 0.017 (0.0013-0.62)% at diagnosis, respectively. Among the bone marrow samples in patients achieved CR, the median percentage of CD34CD38 cells was 0.035 (0.0064-0.66)%, and it was significantly decreased as compared with the percentage at diagnosis (P<0.001); The median percentage of CD34CD38ALDH cells was 0.014 (0.0019-0.24)%, and it showed no different as compared with the percentage at diagnosis (P=0.45). Survival analysis showed that patients with higher percentage of CD34CD38 and CD34CD38ALDH cells at diagnosis tended to the lower 3-year relapse-free survival (RFS) (P=0.27 and 0.21). Furthermore, patients with higher percentage of CD34CD38 and CD34CD38ALDH cells when achieved CR had a significant lower 3-year RFS rates (P=0.010 and 0.0044) as compared with those with lower percentage of CD34CD38 and CD34CD38ALDH cells. Multivariate analysis showed that higher percentage of CD34CD38ALDH cells when achieved CR was an independent factor affecting RFS of the patients.

CONCLUSION

The percentage of CD34CD38ALDH cells at CR in t(8;21) AML patients could predicts relapse, and had more profound predictive significance for relapse than the percentage of CD34CD38 cells.

摘要

目的

探讨高醛脱氢酶（ALDH）活性对t(8;21)急性髓系白血病（AML）患者治疗前后复发的预测意义。

方法

收集2015年4月至2016年6月在我院诊断并获得完全缓解的23例t(8;21) AML患者的骨髓样本，采用流式细胞术检测ALDH活性，并分析其与复发的关系。

结果

所有患者中位随访32（2 - 52）个月。诊断时，有核细胞中CD34⁺CD38⁻和CD34⁺CD38⁻ALDH⁺细胞的中位百分比分别为2.7（0.36 - 35.7）%和0.017（0.0013 - 0.62）%。在达到完全缓解（CR）的患者骨髓样本中，CD34⁺CD38⁻细胞的中位百分比为0.035（0.0064 - 0.66）%，与诊断时相比显著降低（P < 0.001）；CD34⁺CD38⁻ALDH⁺细胞的中位百分比为0.014（0.0019 - 0.24）%，与诊断时相比无差异（P = 0.45）。生存分析显示，诊断时CD34⁺CD38⁻和CD34⁺CD38⁻ALDH⁺细胞百分比越高的患者，其3年无复发生存率（RFS）越低（P = 0.27和0.21）。此外，达到CR时CD34⁺CD38⁻和CD34⁺CD38⁻ALDH⁺细胞百分比高的患者，其3年RFS率显著低于CD34⁺CD38⁻和CD34⁺CD38⁻ALDH⁺细胞百分比低者（P = 0.010和0.0044）。多因素分析显示，达到CR时CD34⁺CD38⁻ALDH⁺细胞百分比高是影响患者RFS的独立因素。