Kuse R, Foures C, Jou J M, d'Onofrio G, Paterakis G
Allgemeines Krankenhaus St Georg, Hamburg, Germany.
Clin Lab Haematol. 1996 Dec;18 Suppl 1:39-43.
Flow cytometric reticulocyte counting including their maturation fractions was performed with a Sysmex R-3000 automated analyser during follow-up after induction and/or consolidation with combination chemotherapy in patients with acute leukaemias (AL, n = 39; 58 courses) and malignant lymphomas (ML, n = 21; 29 courses). The ML patients received granulocyte colony stimulating factor (G-CSF) in addition after chemotherapy. During the leucopenic phase only reticulocytes of low fluorescence ratio (LFR) at extremely low concentration (< 10 x 10(9)/l) were found. After a median interval of 17 days (range 8-43), the middle fluorescence fraction (MFR) began to rise, preceding high fluorescence ratio (HFR) reticulocytes by a median of 1 day in AL patients with complete or partial remission. In ML patients, MFR and HFR reticulocytes appeared more often simultaneously after a median interval of only 11 days (range 8-15) and increased faster during the first week of marrow recovery showing a pattern different from AL. Granulocytes passed the critical limit of 0.5 x 10(9)/l at a median of 5 days after appearance of MFR reticulocytes in AL but in ML on the same day as MFR and HFR (day 0). The absolute reticulocyte concentration reached the lower limit of the reference range after about 10 days in AL. Thus, finding MFR and, to a lesser extent, HFR at very low cell concentrations, may serve as sensitive early indicators of marrow recovery after chemotherapy and are much more sensitive parameters than the absolute reticulocyte concentration. The higher median values for reticulocytes (total, HFR and MFR) after G-CSF therapy suggests that G-CSF is not lineage specific and may also stimulate erythroid precursor cells.
在急性白血病（AL，n = 39；58个疗程）和恶性淋巴瘤（ML，n = 21；29个疗程）患者接受诱导和/或巩固联合化疗后的随访期间，使用Sysmex R - 3000自动分析仪进行流式细胞术网织红细胞计数，包括其成熟分数。ML患者在化疗后还接受了粒细胞集落刺激因子（G - CSF）。在白细胞减少期，仅发现极低浓度（< 10×10⁹/l）的低荧光比率（LFR）网织红细胞。在中位间隔17天（范围8 - 43天）后，中等荧光分数（MFR）开始上升，在完全或部分缓解的AL患者中，高荧光比率（HFR）网织红细胞比MFR晚出现1天。在ML患者中，MFR和HFR网织红细胞在中位间隔仅11天（范围8 - 15天）后更常同时出现，并且在骨髓恢复的第一周增加更快，显示出与AL不同的模式。在AL中，粒细胞在MFR网织红细胞出现后的中位5天达到0.5×10⁹/l的临界值，但在ML中与MFR和HFR同时达到（第0天）。在AL中，绝对网织红细胞浓度在约10天后达到参考范围的下限。因此，在非常低的细胞浓度下发现MFR以及在较小程度上发现HFR，可作为化疗后骨髓恢复的敏感早期指标，并且是比绝对网织红细胞浓度更敏感的参数。G - CSF治疗后网织红细胞（总数、HFR和MFR）的中位数较高，表明G - CSF不是谱系特异性的，也可能刺激红系前体细胞。
