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前体B细胞急性淋巴细胞白血病临床及血液学缓解期儿童骨髓样本中CD10、CD19和CD34标志物的表达

Expression of CD10, CD19 and CD34 markers in bone marrow samples of children with precursor B-cell acute lymphoblastic leukemia in clinical and hematological remission.

作者信息

Cáp J, Babusíková O, Kaiserová E, Jamárik M

机构信息

Department of Childhood Oncology, University Pediatric Hospital, Bratislava, Slovakia.

出版信息

Neoplasma. 1998;45(4):231-6.

PMID:9890666
Abstract

Long-term follow-up of the rate of CD10, CD19 and CD34 antigens expression compared with the percentage of lymphocytes and blastic cells in 196 bone marrow specimens of 91 children with early B-cell acute lymphoblastic leukemia has been performed. It was shown that during a five year period there were no significant differences concerning the percentage of CD markers and the percentage of lymphocytes and blastic cells except those in the 4th year of clinical and immunological follow-up--when increase of lymphocytes and CD19 marker percentage have been observed. Consensus, i.e. more than 20% CD markers positivity associated with more than 5% blasts (positive consensus) or less than 20% CD markers positivity combined with less than 5% blasts (negative consensus) was ascertained in 92.8% of cases. Disagreement, i.e. the rate of CD markers over 20% combined with less than 5% blasts was found in 14 (7.2%) patients. This finding present in the initial phase of the disease could be considered as a sign of not complete remission, in contrast to the finding in children who completed chemotherapy and were in long-term hematological remission, in which the increase of CD markers could be considered as a sign of increased regeneration activity of bone marrow after chemotherapy induced medullary aplasia. Anyway, the increase of CD10, CD19 and CD34 antigens in bone marrow samples over 20% should be evaluated with caution. In these cases, mainly in children with long-term hematologic remission the examination should be repeatedly performed and/or more sensitive methods for detection of minimal residual disease should be applied. In control group of 20 children without leukemia the rate of CD markers in the bone marrow was always under 20%.

摘要

对91例早期B细胞急性淋巴细胞白血病患儿的196份骨髓标本中CD10、CD19和CD34抗原表达率与淋巴细胞及原始细胞百分比进行了长期随访。结果显示,在五年期间,除了临床和免疫随访的第4年观察到淋巴细胞和CD19标记百分比增加外,CD标记百分比与淋巴细胞及原始细胞百分比之间没有显著差异。在92.8%的病例中确定了一致性,即超过20%的CD标记阳性与超过5%的原始细胞相关(阳性一致性)或低于20%的CD标记阳性与低于5%的原始细胞相关(阴性一致性)。在14例(7.2%)患者中发现了不一致情况,即CD标记率超过20%但原始细胞低于5%。与完成化疗并处于长期血液学缓解的儿童的发现相反,疾病初始阶段出现的这一发现可被视为未完全缓解的迹象,在这些儿童中,CD标记的增加可被视为化疗诱导骨髓再生障碍后骨髓再生活性增加的迹象。无论如何,骨髓样本中CD10、CD19和CD34抗原增加超过20%时应谨慎评估。在这些情况下,主要是长期血液学缓解的儿童,应反复进行检查和/或应用更敏感的检测微小残留病的方法。在20例无白血病儿童的对照组中,骨髓中CD标记率始终低于20%。

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