급성백혈병 완전 관해 골수에서 항원형 이상 세포의 분포
Distribution of Antigenic Aberration in the Bone Marrow of Acute Leukemia in Complete Remission
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background : The aberrant, leukemia-associated antigen expression patterns allow us to discriminate leukemic blasts from normal precursor cells. Our major goal was to determine a guideline for the detection of minimal residual disease using CD20+/CD34+ and myeloid Ag+/CD19+ combination in the bone marrow of acute leukemia in complete remission (CR) after chemotherapy. Methods : Bone marrow samples from 117 patients with acute leukemia in complete remission after chemotherapy and from 22 healthy controls were immunophenotyped by triple staining and measured by flow cytometry . Results : The CD20+/CD34+ cells in the large lymphocyte gate (R1) ranged from 0% to 3.24% (0.8±0.82%, P=0.000) in CD20+/CD34+ B-lineage ALL CR (N=31), from 0.03% to 4.2% (0.7±0.83 %, P=0.000) in CD20-/CD34- B-lineage ALL CR (N=66), from 0.1% to 0.96% (0.45±0.32%, P=0.016) in T-ALL CR (N=10), and from 0.02% to 0.48% (0.18±0.15%, P=0.776) in AML CR (N=10). The CD13,33+/CD19+ cells in R1 gate ranged from 0% to 2.69% (0.37±0.48%, P<0.001) in CD13,33+/ CD19+ B-lineage ALL CR (N=31), from 0% to 1.8% (0.31±0.28%, P<0.001) in CD13,33-/CD19+ B-lineage ALL CR (N=65), from 0.02% to 0.64% (0.29±0.22%, P=0.071) in T-ALL CR (N=9), and from 0% to 0.17% (0.07±0.09%, P=0.341) in AML CR (N=3). Conclusions : Using an immunophenotypic method for the detection of early relapse or minimal residual disease of B-lineage ALL bone marrow in CR after chemotherapy, different cutoff values should be applied according to antigen combination and gating. When the proportion of aberrant antigen combination was less than 5% in large lymphocyte gate, the results should be interpreted with caution. (Korean J Lab Med 2008;28:1-7)
Abstract
Background : The aberrant, leukemia-associated antigen expression patterns allow us to discriminate leukemic blasts from normal precursor cells. Our major goal was to determine a guideline for the detection of minimal residual disease using CD20+/CD34+ and myeloid Ag+/CD19+ combination in the bone marrow of acute leukemia in complete remission (CR) after chemotherapy. Methods : Bone marrow samples from 117 patients with acute leukemia in complete remission after chemotherapy and from 22 healthy controls were immunophenotyped by triple staining and measured by flow cytometry . Results : The CD20+/CD34+ cells in the large lymphocyte gate (R1) ranged from 0% to 3.24% (0.8±0.82%, P=0.000) in CD20+/CD34+ B-lineage ALL CR (N=31), from 0.03% to 4.2% (0.7±0.83 %, P=0.000) in CD20-/CD34- B-lineage ALL CR (N=66), from 0.1% to 0.96% (0.45±0.32%, P=0.016) in T-ALL CR (N=10), and from 0.02% to 0.48% (0.18±0.15%, P=0.776) in AML CR (N=10). The CD13,33+/CD19+ cells in R1 gate ranged from 0% to 2.69% (0.37±0.48%, P<0.001) in CD13,33+/ CD19+ B-lineage ALL CR (N=31), from 0% to 1.8% (0.31±0.28%, P<0.001) in CD13,33-/CD19+ B-lineage ALL CR (N=65), from 0.02% to 0.64% (0.29±0.22%, P=0.071) in T-ALL CR (N=9), and from 0% to 0.17% (0.07±0.09%, P=0.341) in AML CR (N=3). Conclusions : Using an immunophenotypic method for the detection of early relapse or minimal residual disease of B-lineage ALL bone marrow in CR after chemotherapy, different cutoff values should be applied according to antigen combination and gating. When the proportion of aberrant antigen combination was less than 5% in large lymphocyte gate, the results should be interpreted with caution. (Korean J Lab Med 2008;28:1-7)
참고문헌 (20)
- Van Wering, E.R., "Regenerating normal B-cell precursors during and after treatment of acute lymphoblastic leukaemia: implications for monitoring of minimal residual disease", Br J Haematol, 110, pp.139~146 (2000)
- Silverman, L.B., "Improved outcome for children with acute lymphoblastic leukemia: results of Dana-Farber Consortium Protocol 91-01", Blood, 97, pp.1211~1218 (2001)
- Schrappe, M., "Improved outcome in childhood acute lymphoblastic leukemia despite reduced use of anthracyclines and cranial radiotherapy: results of trial ALL-BFM 90. German-Austrian- Swiss ALL-BFM Study Group", Blood, 95, pp.3310~3322 (2000)
- Caldwell, C.W., "B-cell precursors in normal pediatric bone marrow", Am J Clin Pathol, 95, pp.816~823 (1991)
- Muehleck, S.D., "Terminal deoxynucleotidyl transferase (TdT)-positive cells in bone marrow in the absence of hematologic malignancy", Am J Clin Pathol, 79, pp.277~284 (1983)
- Longacre, T.A., "Hematogones: a multiparameter analysis of bone marrow precursor cells", Blood, 73, pp.543~552 (1989)
- Davis, R.E., "Hematogones in the bone marrow of adults. Immunophenotypic features, clinical settings, and differential diagnosis", Am J Clin Pathol, 102, pp.202~211 (1994)
- Lucio, P., "BIOMED-I concerted action report: flow cytometric immunophenotyping of precursor B-ALL with standardized triple-stainings. BIOMED-1 Concerted Action Investigation of Minimal Residual Disease in Acute Leukemia: International Standardization and Clinical Evaluation", Leukemia, 15, pp.1185~1192 (2001)
- Ciudad, J., "Immunophenotypic analysis of CD19+ precursors in normal human adult bone marrow: implications for minimal residual disease detection", Haematologica, pp.1069~1075 (1998)
- Vogel, P., "Sternal marrow of children in normal and pathologic states", Am J Dis Child, 57, pp.245~268 (1939)
- Mckenna, R.W., "Immunophenotypic analysis of hematogones (B-lymphocyte precursors) and neoplastic lymphoblasts by 4-color flow cytometry", Leuk Lymphoma, 45, pp.277~285 (2004)
- Van Dongen, J.J., "Detection of minimal residual disease in acute leukemia patients", Cytokines Mol Ther, 2, pp.121~133 (1996)
- Ciudad, J., "Detection of abnormalities in B-cell differentiation pattern is a useful tool to predict relapse in precursor- B-ALL", Br J Haematol, 104, pp.695~705 (1999)
- Dworzak, M.N., "Comparative phenotype mapping of normal vs malignant pediatric B-lymphopoiesis unveils leukemia-associated aberrations", Exp Hematol, 26, pp.305~313 (1998)
- Cap, J., "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", Neoplasma, 45, pp.231~236 (1998)
- Hurwitz, C.A., "Asynchronous antigen expression in B lineage acute lymphoblastic leukemia", Blood, 72, pp.299~307 (1988)
- Dworzak, M.N., "Multiparameter phenotype mapping of normal and postchemotherapy B lymphopoiesis in pediatric bone marrow", Leukemia, 11, pp.1266~1273 (1997)
- Ciudad, J., "Detection of abonormalities in B-cell differentiation pattern is a useful tool to predict relapse in precursor- B-ALL", Br J Hematol, 104, pp.695~705 (1999)
- Farahat, N., "Detection of minimal residual disease in Blineage acute lymphoblastic leukaemia by quantitative flow cytometry", Br J Haematol, 101, pp.158~164 (1998)
- Lavabre-Bertrand, T., "Porwit-MacDonald A. Leukemia-associated changes identified by quantitative flow cytometry: I. CD10 expression", Cytometry, 18, pp.209~217 (1994)