Dörmer P, Hershko C, Wilmanns W
Institut für Experimentelle Hämatologie, München, F.R.G.
Br J Haematol. 1987 Oct;67(2):147-52. doi: 10.1111/j.1365-2141.1987.tb02318.x.
Cell kinetics were studied by quantitative autoradiography in 29 patients with myelodysplastic syndromes (MDS) and in four with smouldering leukaemia (SML) in a prospective 6-year study. Cellular turnover in all FAB groups was characterized by reduced labelling index and prolonged DNA synthesis time indicating reduced proliferative activity. Two more parameters were derived from the measurements. (1) The relative cell production rate, which is increased in proerythroblasts and myeloblasts in most cases. This could be attributed to an increased number of divisions in early recognizable precursors in the absence of maturation, and (or) an increased influx from the progenitor compartments. (2) The maturation index of a cell lineage was determined by the ratio of relative cell production rate increase from the first to the last proliferative compartment over the corresponding normal value. It showed a high degree of abnormality in all FAB subgroups, indicating premature cell death in the bone marrow. None of the kinetic parameters proved to be of value in predicting the evolution of leukaemia. In contrast, an excellent correlation was found between the myeloid maturation index and survival (P less than 0.0001). No correlation, however, was found between survival and the erythroid maturation index, which was relatively normal in the worst prognostic group. These findings indicate that although in vitro cell kinetic studies can not predict the evolution of overt leukaemia, the myeloid maturation index is a useful predictor of survival in patients with MDS and SML.
在一项为期6年的前瞻性研究中，通过定量放射自显影术对29例骨髓增生异常综合征（MDS）患者和4例冒烟型白血病（SML）患者的细胞动力学进行了研究。所有FAB组的细胞更新均表现为标记指数降低和DNA合成时间延长，表明增殖活性降低。从这些测量中还得出了另外两个参数。（1）相对细胞产生率，在大多数情况下，早幼红细胞和原粒细胞中的相对细胞产生率会升高。这可能归因于早期可识别前体细胞在未成熟情况下分裂次数增加，和（或）祖细胞区室流入增加。（2）细胞系的成熟指数通过从第一个到最后一个增殖区室相对细胞产生率增加的比值除以相应的正常值来确定。它在所有FAB亚组中均显示出高度异常，表明骨髓中细胞过早死亡。没有一个动力学参数被证明对预测白血病的演变有价值。相反，发现髓系成熟指数与生存率之间存在极好的相关性（P小于0.0001）。然而，在预后最差的组中相对正常的红系成熟指数与生存率之间未发现相关性。这些发现表明，尽管体外细胞动力学研究无法预测明显白血病的演变，但髓系成熟指数是MDS和SML患者生存率的有用预测指标。
