The Clinical Significance Of Reticulated Platelet In Acute Leukemia

Objective Using Flow cytometric method to explore the blood Reticulated Platelet changing regularity in acute leukemia and evaluate its significance in predicting the recovery of thrombopoisis and hemopoisis , estimating the treatment effect and guiding the treatment.Methods 32 AL patients including in 19 primary acute non-lymphocytic leukemia(ANLL),5 primary acute lymphoblastic leukemia(ALL),9 consolidation chemotherapy leukemia and 4 refractory and relapse leukemia during and after chemotherapy were studied. 12 healthy volunteers served as normal controls. Dynamic observation was made during the treatment . RP in platelet-rich plasma was detected by FCM method. The differences of the RP absolute value and its percentage between the normal controls and the different stages during treatment of acute leukemia were analysed.Results 1. The absolute value (RP) and percentage of RP(RP%) in 32 acute leukemia patients are (4. 05 3. 82) X10VL, (11.63+14.01)% respectively , RPs are different to normal controls (18. 16 + 27. 10) X 109/L, (p<0. 05), the RP, RP% of ANLL are (3.38 + 3.17) X 109 and (13. 19+ 16. 09)% respectively, they are no significance to the RP (5.76 + 4.92) X 109, RP% (7. 64 4. 85)% of ALL.2. The RPs of 19 primary AL patients before chemotherapy are (4. 00 + 3. 98) X109/L, lower than normal control (P<0. 05), while RP%s (14.27+13.00) % are no difference to normal controls (P>0.05) ; the RPs in myelosuppress stage and recovery stage are( 1. 34 + 2. 00) X 109/L, (2. 90 + 3. 27) X 103/L respectively , lower than normal controls (P<0. 05), while the RP%s in these two stages are(14.53+15.23)%, (17. 19 8. 68) %, the RPs , RP%s of 4 refractory or relapse leukemiasare (4.00 + 6.37) X 109/L and (19. 54 + 25. 20) %, RPs are lower than normorl control while RP%s are no significant difference; the RPs , RP%s of 9 consolidate chemotherapy patients are (6. 18 2. 34) X109/Land (2. 55 1. 17) %.3. The RPs of 14 AL patients with complete remission before chemotherapy are(4. 63 + 3. 33) X109/L, reduced to(l. 93 1. 59) X 109/L after chemotherapy (P<0.05), while the RP^ RP% of 5 AL patients without remission before chemotherapy are(4. 67 + 5. 21) X 109/L, (11. 15 + 7. 77)%, increased to (9.37 + 12. 20)X109/L and (21. 54 + 11. 07)%respectively after chemotherapy (P<0. 05).4 . The RPs, RP%s of 7 primary AL patients before and after chemotherapy , in myelosuppression stage and recovery stage are (4. 83 + 4. 62) X 109/L, (1.40 + 1. 46) X 10VL, (0. 73 0. 38) X lO'/L, (1. 97 + 0. 81) X 109/L, (14. 86 + 8. 60)%, (7. 92 + 4.76)%, (11.59 + 10.39)%, (18. 18 + 5. 49)%, the RP , RP% after chemotherapy and in myelosuppression stage are both lower than in recovery stage and before chemotherapy (P<0. 05) .Conclusion 1.Our date provided that it is simple .accurate and sensitive to determine the RPs level by FCM.2. The RP , RP% in the different stages of acute leukemia are different . the absolute value of RP in primary leukemia decreases and it is higher in recovery stage than in myelosuppress stage. The RP , RP% have no relative to the classification and property of leukemia.3.It is a sensitive index to predict the recovery of bone marrow after chemotherapy, the increase of RP% and RP are earlier than PLT, and the RP and RP% in recovery stage are higher than in myelosuppressin stage.the RPand RP% both in myelosuppression stage and after chemotherapy are lower than before chemotherapy.4. The RP% of AL without remission after chemotherapy is higher than before chemotherapy, the data can be useful to know the status of the ill .guide the treatment , estimatate the effect and prognosis.