RESUMEN
Based on the leukemia-associated immunophenotypes (LAIPs), minimal residual disease (MRD) related to the outcome can be detected by multiparameter flow cytometry in acute myeloid leukemia (AML) patients. Although 0.1% was commonly used as a cutoff value, measurable MRD or MRD level below 0.1% has also been associated with prognostic significance and more sensitive thresholds (<0.1%) are required for improving AML prognosis prediction. In this study, 292 adult patients diagnosed with AML (non-M3) were enrolled, 36 kinds of LAIPs were identified, and the baseline expression levels in normal or regenerating bone marrows of each kind of LAIP were established, which ranged from <2.00 × 10-5 to 5.71 × 10-4 . The baseline level of each LAIP was considered as the individual threshold for MRD assessment. MRD statuses stratified by 0.1% and individual threshold were termed as 0.1%-MRD and individual-MRD, respectively. The patients of individual-MRDneg showed significantly better survival compared with those of 0.1%-MRDneg /individual-MRDpos or 0.1%-MRDpos . Multivariate analysis showed that when time points of complete remission, post the first and second consolidation courses, were considered, only individual-MRD post second consolidation presented independent prognostic value. Notably, in patients of cytogenetic/molecular low-risk (LR) or intermediate-risk (IR), the individual-MRD status could identify the patients with significantly different outcomes, while 0.1%-MRD status could not. Furthermore, among the patients of the LR or IR group which received chemotherapy only, those with individual-MRDneg status presented favorable survival, which was comparable with that of the patients accepted allogeneic hematopoietic stem cell transplantation (ASCT). This approach is useful in the selection of an ASCT strategy for clinical practice.
Asunto(s)
Médula Ósea , Trasplante de Células Madre Hematopoyéticas , Leucemia Mieloide Aguda , Adolescente , Adulto , Anciano , Aloinjertos , Médula Ósea/metabolismo , Médula Ósea/patología , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Inmunofenotipificación , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/mortalidad , Leucemia Mieloide Aguda/patología , Leucemia Mieloide Aguda/terapia , Masculino , Persona de Mediana Edad , Neoplasia Residual , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To investigate the charactcristics of CD180 expression and differentiation diagnostic value in B cell chronic lymphoproliferative disorders (B-CLPD) through detecting the mean fluorescence intensityï¼MFIï¼of CD180 in different sub types of B-CLPDï¼using multiparameter flow cytometry (FCM). METHODS: The CD180 MFI of malignant B cells in 178 patients with B-CLPD was detected by FCM. The level of CD180 MFI in various types of B-CLPD was compared to the normal control group. The level of CD180 MFI among sub-types of B-CLPD was also compared. RESULTS: (1) The expression levels of CD180 in B-CLPD was significantly lower as compared with the normal controlsï¼except the spleen difuse red pulp lymphoma (SDRPL); (2) The CD180 MFI in chronic lymphocytic leukemia sCLL) was significantly lower as compared with other B-CLPD cells; (3) CD180 ware significantly overexpressed in HCL compared with MCLï¼LPLï¼and MZL (P <0.05); (4) In the spleen-derived B-CLPDï¼such as SMZLï¼HCL, HCL variation and SDRPLï¼the expression of CD180 has significant difference between lymphomas with or without villous. CONCLUSION: Utilizing the multiparameter flow cytometry for defecting expression of CD180 and other immunological markers can more efficiently distinguish the subtypes of B-CLPD.