Tuncer A M, Hiçsönmez G, Gümrük F, Albayrak D, Duru F, Güzel E, Sayli T
University of Hacettepe, Hacettepe Children's Hospital, Department of Pediatric Hematology, Ankara, Turkey.
Hematol Pathol. 1994;8(4):169-75.
The expression of CD34 antigen on the surface of bone marrow cells during remission induction was studied in 27 selected acute lymphoblastic leukemia (ALL) patients who were CD34 negative at presentation and were stratified to receive high-dose methylprednisolone (30 mg/kg/day po) or conventional-dose prednisolone (2 mg/kg/day po). Patients received either induction with L-Asparaginase, vincristine (VCR), and high-dose methylprednisolone [HDMP, 30 mg/kg/day po for 1 week, 20 mg/kg/day po for 1 week, and 20 mg/kg/day po every other day for 2 more weeks (20 patients)], or identical induction in which HDMP was replaced by prednisolone 2 mg/kg/day by mouth for 4 weeks (8 patients). Bone marrow cells from all patients were studied 1,2, and 4 weeks after initiation of treatment for expression of the CD34 antigen using a three-step indirect immunoperoxidase staining technique. In the 20 patients with ALL who received HDMP the percentage of normal bone marrow cells expressing CD34 was significantly higher (p < 0.05) than in the 8 patients who did not receive HDMP. The mean percentage of CD34-positive bone marrow cells during the fourth week was 17.2% in patients with ALL who received HDMP, whereas patients who received 2 mg/kg prednisolone per day had only 6.1% CD34 cells in the marrow. Absolute polymorphonuclear leukocyte (pmnl) count was also significantly higher in the patients who received HDMP in the second and third week of therapy [(absolute pmnl count was 2197.7/mm3 in the second week and 4091.8/mm3 in the fourth week in the patients who received HDMP compared to 974.4/mm3 and 1556.5/mm3 in the patients who did not receive HDMP) (p < 0.05)].(ABSTRACT TRUNCATED AT 250 WORDS)
对27例初诊时CD34阴性的急性淋巴细胞白血病（ALL）患者进行了研究，这些患者被分层接受高剂量甲泼尼龙（30mg/kg/天，口服）或常规剂量泼尼松龙（2mg/kg/天，口服），观察缓解诱导期骨髓细胞表面CD34抗原的表达情况。患者接受以下两种诱导方案之一：一种是使用左旋门冬酰胺酶、长春新碱（VCR）和高剂量甲泼尼龙[HDMP，30mg/kg/天，口服1周，20mg/kg/天，口服1周，之后每2天20mg/kg/天，口服2周（20例患者）]；另一种是相同的诱导方案，但将HDMP替换为2mg/kg/天的泼尼松龙口服4周（8例患者）。在治疗开始后的第1、2和4周，采用三步间接免疫过氧化物酶染色技术研究所有患者骨髓细胞中CD34抗原的表达。在接受HDMP的20例ALL患者中，表达CD34的正常骨髓细胞百分比显著高于未接受HDMP的8例患者（p<0.05）。接受HDMP的ALL患者在第4周时，CD34阳性骨髓细胞的平均百分比为17.2%，而每天接受2mg/kg泼尼松龙治疗的患者骨髓中CD34细胞仅为6.1%。在治疗的第2周和第3周，接受HDMP的患者绝对多形核白细胞（pmnl）计数也显著更高[接受HDMP的患者第2周绝对pmnl计数为2197.7/mm3，第4周为4091.8/mm3，而未接受HDMP的患者分别为974.4/mm3和1556.5/mm3（p<0.05）]。（摘要截断于250字）
