急性髓系白血病患者白血病干细胞（CD34/CD38/TIM3）频率：临床意义。

Leukemic Stem Cell (CD34/CD38/TIM3) Frequency in Patients with Acute Myeloid Leukemia: Clinical Implications.

机构信息

Biochemistry Section, Oncology Center Laboratories, Oncology Center, Mansoura University, Mansoura, Egypt.

Hematology Unit, Clinical Pathology Department, Oncology Center, Mansoura University, Mansoura, Egypt.

出版信息

Clin Lymphoma Myeloma Leuk. 2021 Aug;21(8):508-513. doi: 10.1016/j.clml.2021.03.009. Epub 2021 Mar 27.

DOI:10.1016/j.clml.2021.03.009

PMID:33931379

Abstract

This study aimed to address the prognostic relevance of CD34/CD38/TIM3 leukemic stem cell (LSC) frequency in patients with acute myeloid leukemia (AML) and its impact on patient outcome. We analyzed the expression of LSC markers (CD34/CD38/TIM3) using flow cytometry in bone marrow samples of 53 AML cases before and after induction chemotherapy. The LSC frequency at diagnosis was significantly higher compared with that postinduction (P < .001). Patients were categorized into high LSC expressers (≥ median) and low expressers (< median). Patients with AML with high number of LSCs at diagnosis had significantly lower induction of remission response (P = .0104), shorter disease-free survival, and shorter overall survival (P < .001 for both) compared with those with lower LSC count. Cox regression analysis revealed that LSC frequency at diagnosis is an independent prognostic factor in AML. Assessment of LSCs (CD34/CD38/TIM3) at diagnosis is recommended for refining of AML risk stratification.

摘要

本研究旨在探讨急性髓系白血病（AML）患者中 CD34/CD38/TIM3 白血病干细胞（LSC）频率的预后相关性及其对患者结局的影响。我们使用流式细胞术分析了 53 例 AML 患者诱导化疗前后骨髓样本中 LSC 标志物（CD34/CD38/TIM3）的表达。诊断时的 LSC 频率明显高于诱导后（P <.001）。将患者分为高 LSC 表达者（≥中位数）和低表达者（<中位数）。与 LSC 计数较低的患者相比，诊断时 LSC 数量较高的 AML 患者缓解诱导反应明显降低（P =.0104），无病生存期和总生存期更短（两者均 P <.001）。Cox 回归分析显示，诊断时的 LSC 频率是 AML 的独立预后因素。建议在诊断时评估 LSCs（CD34/CD38/TIM3），以细化 AML 的风险分层。