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目的观察流式细胞术(FCM)检测急性白血病微小残留病(MRD)的临床意义。方法选取医院血液科初诊并通过诱导治疗后达完全缓解的急性白血病患者40例为研究对象,于首次诱导化疗结束、巩固化疗3个月、巩固化疗6个月、巩固化疗12个月应用FCM定期检测患者骨髓标本,同时检测骨髓细胞形态学的变化,以MRD>10-4为阳性,否则为阴性。患者首次诱导化疗结束后MRD水平分为高(MRD≥10~(-2))、中(10~(-2)0.05)。结论 FCM检测急性白血病微小残留病(MRD)对诊断急性白血病的复发及指导个体化治疗有重要意义。
Objective To observe the clinical significance of Flow Cytometry (FCM) in the detection of minimal residual disease (MRD) in acute leukemia. Methods Forty patients with acute leukemia who were newly diagnosed by hospital hematology department and reached complete remission after induction therapy were enrolled in this study. After the first induction chemotherapy, consolidation chemotherapy for 3 months, consolidation chemotherapy for 6 months, consolidation chemotherapy for 12 months, The bone marrow samples of patients were detected and the morphological changes of bone marrow cells were detected. MRD> 10-4 was positive, otherwise negative. The level of MRD in the patients after the first induction chemotherapy was high (MRD≥10 ~ (-2)), middle (10 ~ (-2) MRD≤10), low (MRD≤10 ~ (-4) )) 3 levels. The χ ~ 2 test was used to compare the difference between the first induction chemotherapy, consolidation chemotherapy for 3 months, consolidation chemotherapy for 6 months, consolidation recurrence rate of MRD positive group and MRD negative group after 12 months of chemotherapy, High, medium and low 3 groups recurrence rate difference. Results The positive rate of MRM in bone marrow MRD positive group after chemotherapy was 3 months, consolidation chemotherapy was 6 months, and recurrence rate was 25.0%, 18.9%, 18.5% and 20.0% respectively in 12 months of consolidation chemotherapy. MRD negative group All are 0 MRD-positive group compared with MRD-negative group, the first induction chemotherapy was completed, consolidation chemotherapy for 3 months, consolidation chemotherapy for 6 months, consolidation chemotherapy for 12 months, 4 time points recurrence rate difference was statistically significant (P <0.01 ). The relapse rate of high bone MRD bone marrow group after the first induction chemotherapy was higher than that of middle and low bone marrow group, with significant difference (P <0.01). There was no significant difference in relapse rate between the middle level group and the low level group (P> 0.05). Conclusion FCM detection of acute leukemia minimal residual disease (MRD) is of great importance in the diagnosis of acute leukemia relapse and individualized treatment.