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[多色流式细胞术检测急性髓系白血病微小残留病]

[Detection of Minimal Residual Disease in Acute Myeloid Leukemia by Multi-color Flow Cytometry].

作者信息

He Chen, Zhang Qiu-Tang, Tang Ping, Sun Hui

机构信息

Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China.

Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China,E-mail:

出版信息

Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2022 Apr;30(2):341-345. doi: 10.19746/j.cnki.issn.1009-2137.2022.02.003.

Abstract

OBJECTIVE

To establish 10-color fluorescent antibody combination panels for the detection of minimal residual disease (MRD) of acute myeloid leukemia (AML) in our laboratory and discuss the value of clinical application.

METHODS

According to the antigen expression characteristics of leukemia cells of incipient AML patients, MRD in bone marrow were detected by multiparameter flow cytometry, and the test results were compared with both bone marrow cell morphology and PCR results, then 10-color fluorescent antibody combination panels in our lab for MRD detection was determined.

RESULTS

The immunophenotypic characteristics of 392 incipient patients with AML in the First Affiliated Hospital of Zhengzhou University were analyzed, among them 357 (91.07%) cases showed abnormal immunophenotypes, which mainly included cross-lineage expression, cross-stage expression, deficiency of antigen expression or abnormal antigen intensity and other abnormal expression. The 10-color fluorescent antibody combination panels established according to abnormal immunophenotypic characteristics of leukemia cells were applied for detecting MRD in 156 patients with AML, the positive rate (43.6%) was higher than 26.8% of morphology, and the results were highly consistent with PCR detection results (96.49%), moreover, the recurrence rate of MRD positive patients (86.96%) was significantly higher than 5.75% of MRD negative patients. Therefore, this method could truly reflect the load of leukemia cells and prompt change of disease condition.

CONCLUSION

Multiparameter flow cytometry can detect various abnormal immunophenotypes of AML. The 10-color fluorescent antibody combination panels in our lab based on the characteristics of antigens expression in leukemia cells can well detect MRD of leukemia cells, so as to predict relapse and provide basis for clinical treatment.

摘要

目的

建立本实验室用于检测急性髓系白血病(AML)微小残留病(MRD)的十色荧光抗体组合方案,并探讨其临床应用价值。

方法

根据初诊AML患者白血病细胞的抗原表达特征,采用多参数流式细胞术检测骨髓中的MRD,并将检测结果与骨髓细胞形态学及PCR结果进行比较,从而确定本实验室用于MRD检测的十色荧光抗体组合方案。

结果

分析郑州大学第一附属医院392例初诊AML患者的免疫表型特征,其中357例(91.07%)呈现免疫表型异常,主要包括跨系表达、跨阶段表达、抗原表达缺失或抗原强度异常等异常表达。根据白血病细胞异常免疫表型特征建立的十色荧光抗体组合方案应用于156例AML患者MRD检测,阳性率(43.6%)高于形态学的26.8%,且结果与PCR检测结果高度一致(96.49%),此外,MRD阳性患者的复发率(86.96%)显著高于MRD阴性患者的5.75%。因此,该方法能真实反映白血病细胞负荷及病情变化。

结论

多参数流式细胞术可检测AML的各种异常免疫表型。本实验室基于白血病细胞抗原表达特征建立的十色荧光抗体组合方案能很好地检测白血病细胞MRD,从而预测复发并为临床治疗提供依据。

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