| Objective:To detect the expression of Leukemia stem cells (LSCs) related genes (abcb1, bmi-1, hoxb4) in the patients with acute leukemia, and explore its clinical significance in acute leukemia, obtain a good indicator for assessing the therapeutic efficacy/prognosis of acute leukemia.Methods:Bone marrow samples were collected from the patients in Tianjin first central hospital, include initial acute leukemia patients (41cases), the acute leukemia patients in CR phase (16cases) and the patients without malignant hemotalogy diseases (10cases), respectively. And the expressions of abcbl, bmi-1, hoxb4genes were detected by comparative real-time reverse transcriptase-polymerase chain reaction (RT-PCR) with SYBR Green assay. The relationship between LSCs related genes and ages, FAB subtype, remission rate, immunophenotype, chromosomes karyotype and white blood counting were analyzed.Results:1. The expressions of abcb1, bmi-1, hoxb4were not detected in the patients without malignant diseases, but were higher in the initial acute leukemia patients(relative expressive level:4.26±2.26,3.72±1.91,3.74±2.38) and lower in the acute leukemia patients in CR phase(relative expressive level:2.14±1.47,2.07±0.99,1.47±0.89)(p<0.05). In the initial acute leukemia patients, the expressions of abcbl, bmi-1, hoxb4were different in different FAB subtypes:the expression level were lower in M2, M3, B-ALL, and higher in M4, M5, M6, T-ALL, there was significant difference only between M3and the initial group(p<0.05).2. The expressions of LSCs related genes were lower in the patients acquired CR/PR (relative expressive level:1.77±1.29,2.09±1.26,1.78±1.49) than in the patients not acquired CR/PR (relative expressive level:7.23±1.78,3.96±0.92,4.48±2.57)(p<0.01).3. Single-index analysis revealed:①The CR/PR rates were lower in the patients with any higher expression of LSCs relate genes than in the patients with any lower expression(p<0.05).②There were more cases with the expression of LSCs immunophenotype (CD34+CD38-CD96+and CD34+CD38"CD123+) with any higher expression of LSCs relate gene (p<0.05).③There were more hyper-leukocytes cases in patients with any higher expression of LSCs related gene (p<0.05).4. Multi-genes analysis:the higher expressed group included that two or three genes was defined as higher expression, and the lower expressed group included that no gene or only one gene was higher expression. Synthetical analyze the expressions of LSCs related genes discovered larger significance(p<0.01).①The CR/PR rates were lower in the higher expressed group than in the lower expressed group(p<0.01).②There were more cases with the expression of LSCs immunophenotype (CD34+CD38-CD96+and CD34+CD38-CD123+) with higher expressed group (p<0.01).③There were more hyper-leukocytes cases in patients with higher expressed group (p<0.01).Conclusions:The expression of LSCs related genes(abcbl, bmi-1, hoxb4) were higher in initial acute leukemia patients, and lower when they acquired CR/PR. And there was a good relationship between LSCs related genes and LSCs immunophenotype. The patients with higher expression LSCs related genes showed higher hyper-leukocytes, worse response to chemotherapy and lower CR/PR rate. And multi-genes analysis discovered larger significance which suggested that they might be a good indicator for assessing the therapeutic efficacy/prognosis of acute leukemia. |
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