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目的 探讨急性早幼粒细胞白血病 (APL)患者血清对正常粒 单核系祖细胞 (CFU GM )生长的影响及其抑制活性变化的有关因素。方法 用细胞培养方法动态观察了 2 4例APL患者在全反式维甲酸 (ATRA)治疗过程中 ,其血清对正常CFU GM生长的影响 ;用ELISA和生物活性法分别检测血清中粒细胞集落刺激因子 (G CSF)、γ干扰素 (IFN γ)及肿瘤坏死因子 (TNF)活性。结果 治疗前 ,血清对CFU GM的生长呈抑制作用 ,抑制活性明显高于骨髓缓解时和正常血清 (P <0 0 1) ;治疗过程中 ,血清对CFU GM的抑制活性逐渐加强 ,在白细胞达高峰前 3～ 6天最强 ,然后逐渐减弱 ;骨髓缓解时 ,血清对CFU GM的抑制活性明显下降 ,与正常血清比较 ,差异无统计学意义。血清对正常CFU GM抑制活性与患者骨髓白血病祖细胞 (CFU L)、早幼粒细胞百分率呈正相关 ,与骨髓CFU GM呈负相关 ,与血清G CSF含量或TNF活性间无线性相关。血清IFN γ活性为阴性。结论 ①未治疗的APL患者血清对正常粒 单核系造血有抑制作用。ATRA治疗APL取得缓解的机制之一 ,是通过诱导白血病细胞分化成熟 ,造血抑制活性不断减低 ,正常造血得以恢复 ;②血清抑制活性的异质性除与白血病细胞有关外 ,尚与其它细胞因子参与有关
Objective To investigate the effect of serum from patients with acute promyelocytic leukemia (APL) on the growth of normal mononuclear progenitor cells (CFU GM) and the related factors of changes in inhibitory activity. Methods The effect of serum on the growth of normal CFU GM in 24 patients with APL was observed by cell culture method. The serum granulocyte colony stimuli were detected by ELISA and bioactivity assay, respectively. Factors (G CSF), gamma interferon (IFN γ), and tumor necrosis factor (TNF) activity. Results Before treatment, the serum inhibited the growth of CFU GM, and the inhibitory activity was significantly higher than that in the bone marrow during remission and normal serum (P <0 01). During the treatment, the inhibitory activity of serum on CFU GM was gradually strengthened, and the leukocyte count was increased. The peak intensity was 3 to 6 days before the peak, and then gradually weakened; when the bone marrow was relieved, the inhibitory activity of serum on CFU GM was significantly decreased, compared with normal serum, the difference was not statistically significant. The inhibitory activity of serum on normal CFU GM was positively correlated with the percentage of myeloid leukemia progenitor cells (CFU L) and promyelocytic cells, negatively correlated with bone marrow CFU GM, and correlated with serum G CSF content or TNF activity. Serum IFN gamma activity was negative. Conclusion 1 Serum from untreated APL patients has inhibitory effects on normal mononuclear hematopoiesis. One of the mechanisms that ATRA treats APL to achieve remission is to induce differentiation and maturation of leukemia cells, reduce hematopoietic inhibitory activity, and restore normal hematopoiesis; 2 Heterogeneity of serum inhibitory activity is related to other leukemia cells, but is involved in other cytokines. related