Ding Li-Li, Xiong Hao, Yang Li, Chen Yan, DU Yu, Lu Wen-Jie, Qi Shan-Shan, Chen Zhi, Sun Ming, Luo Lin-Lin
Department of Hematology &Oncology, Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology， Wuhan 430016, Hubei Province, China.
Department of Hematology &Oncology, Wuhan Children's Hospital Affiliated to Tongji Medical College of Huazhong University of Science & Technology， Wuhan 430016, Hubei Province, China,E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2023 Jun;31(3):654-658. doi: 10.19746/j.cnki.issn.1009-2137.2023.03.006.
To study the cerebrospinal fluid (CSF) status and prognosis value in patients with newly diagnosed acute lymphoblastic leukemia (ALL) by flow cytometry (FCM).
The clinical features of the 75 newly diagnosed ALL patients from September 2020 to December 2021 in our centre were retrospective analyzed, as well as the bone marrow (BM) and CSF minimal residual disease (MRD) data, and the CSF conventional cytology data. Central nervous system infiltration(CNSI) positive was as CSF MRD positive by FCM or leukemia cells detected by conventional cytology. The status of CSF were compared and analyzed by FCM and conventional cytology, the clinical features and the prognosis value of different CNSI status in these patients were analyzed.
Among 75 newly diagnosed ALL, 16 cases (21%) with CNSI positive (CNSI) were detected by FCM, while only 2 positive cases (3%) were detected by conventional cytology. The CNSI rate detected by FCM was significantly higher than conventional cytology(<0.05). Compared with CNSI ALL patients, the median age of CNSI ALL patients was significantly younger, and the median platelet count was significantly lower, the difference was statistically significant (<0.05). Up to follow-up time (August 31, 2022), four ALL patients were died, including 3 patients were CNSI and 1 patient was CNSI. Furthermore, three cases were primary disease relapse, including 1 case was CNSI. There was no significant difference in overall survival (OS) rate and relapse-free survival (RFS) rate of the patients with different CNSI status.
Compared with conventional cytology, FCM is a more sensitive assay to evaluate the central nervous system status in ALL patients. After active treatment, there was no significant difference in OS and RFS between patients with different CNSI status at diagnosis.
通过流式细胞术（FCM）研究新诊断急性淋巴细胞白血病（ALL）患者的脑脊液（CSF）状况及预后价值。
回顾性分析2020年9月至2021年12月在本中心新诊断的75例ALL患者的临床特征、骨髓（BM）和脑脊液微小残留病（MRD）数据以及脑脊液常规细胞学数据。中枢神经系统浸润（CNSI）阳性定义为FCM检测脑脊液MRD阳性或常规细胞学检测到白血病细胞。采用FCM和常规细胞学方法比较分析脑脊液状况，分析这些患者不同CNSI状态的临床特征及预后价值。
75例新诊断的ALL患者中，FCM检测到16例（21%）CNSI阳性（CNSI），而常规细胞学仅检测到2例阳性（3%）。FCM检测的CNSI率显著高于常规细胞学（<0.05）。与非CNSI ALL患者相比，CNSI ALL患者的中位年龄显著更小，中位血小板计数显著更低，差异有统计学意义（<0.05）。截至随访时间（2022年8月31日），4例ALL患者死亡，其中3例为CNSI，1例为非CNSI。此外，3例出现原发性疾病复发，其中1例为CNSI。不同CNSI状态患者的总生存率（OS）和无复发生存率（RFS）无显著差异。
与常规细胞学相比，FCM是评估ALL患者中枢神经系统状况更敏感的检测方法。积极治疗后，诊断时不同CNSI状态患者的OS和RFS无显著差异。
