急性白血病患者造血干细胞P-选择素表达的研究

目的 研究急性白血病(AL)患者骨髓白血病干细胞表面分子P-选择素(CD62P)的表达情况及其临床意义.方法 采用流式细胞术(FCM)检测56例初治AL患者骨髓CD62P的表达情况,以15例健康成年人骨髓标本为对照.结果 38例急性髓系白血病(AML)患者干细胞(CD+45CD+34CD-38)中CD62P平均表达水平为(6.72±7.64)%,12例急性B淋巴细胞白血病(B-ALL)患者干细胞(CD+45CD+34CD+19)为(3.46±2.51)%,6例急性T淋巴细胞白血病(T-ALL)患者干细胞(CD+45 CD+34CD+7)为(6.23±4.95)%,均明显高于健康对照组(1.04±1.23)%](t值分别为2.847、3.284、3.091,P＜0.01).经过正规方案治疗后,完全缓解组患者CD62P表达与健康对照差异无统计学意义(t=0.397,P＞0.05).另外CD+62P的AML及T-ALL患者白细胞计数、血红蛋白及血小板计数均明显高于CD-62P患者(t值分别为4.153、8.095、8.289、7.235、8.692、9.832,P＜0.05);而CD+62P与CD-62P的B-ALL患者无明显差异(t值分别为0.340、1.142、0.019,P＞0.05).结论 CD62P是血小板活化的标志物之一,在不同类型的AL中有不同程度的表达.AL骨髓造血干细胞中CD62P可能作为白血病造血干细胞的标志,以及临床疗效观察预后判断的指标之一.

Expression of P-selectin in hematopoietic stem cells of patients with acute leukemia

Objective To investigate the expression and clinical significance of P-selectin (CD62P) in bone marrow hematopoietic stem cells of patients with acute leukemia (AL). Methods The CD62P expression in bone marrow mononuclear cells of 15 healthy donors and 56 untreated patients with AL, were examined by flow cytometry. Results The average rate of CD62P expression was (6.72±7.64) % in hematopoietic stem cells (CD+45 CD+34 CD-38) of the 38 patients with acute myeloid leukemia (AML), was (3.46±2.51) % in hematopoietic stem cells (CD+45 CD+34 CD+19) of the 12 patients with B-acute lymphoblastic leukemia (B-ALL), and was (6.23±4.95) % in hematopoietic stem cells (CD+45 CD+34 CD+7) of 6 patients with T-acute lymphoblastic leukemia (T-ALL). The expression rates in those AL patients were higher than that in the healthy controls (1.04 ±1.23) % (t = 2.847, 3.284, 3.091, respectively, P ＜0.01), while there was no difference between the control group and the group who reach CR after routine treatment (t =1.932, P ＞0.05). Furthermore, the leukocyte,hemoglobin and platelet count in CD+62P patients with AML and T-ALL were significantly higher than CD-62P ones (t =4.153, 8.095, 8.289, 7.235, 8.692, 9.832, respectively, P ＜0.05), but there was no significant difference between CD+62P and CD-62P patients with B-ALL (t =0.340, 1.142, 0.019, respectively, P ＞0.05).Conclusion The CD62P is one of the markers of platelet activation, and its expression varies in different types of AL. The CD62P in hematopoietic stem cells of AL could be regarded as a new sign for the leukemic stem cells, as well as a helpful prognostic indicator in treatment response assessment.