| Background Acute lymphoblastic leukemia(ALL)patients had a significant improvement in the remission rate after systemic chemotherapy,but about 20% of patients still had poor prognosis and eventually died of recurrence.Minimal residual disease(MRD)is the root cause of ALL relapse.Flow cytometry instrument is one of the technology of detecting MRD,lower level index of leukemia cells can be detected,but B lymphocytic leukemia patients hyperplasia period after treatment with normal B progenitor cells in bone marrow,so detection is relatively complex,need to find more leukemia related immune phenotype(LAIP)FCM analysis,tags in order to improve the detection rate,more accurately evaluate the prognosis of patients with recurrence and trend,provide reference for clinical intervention.Objective To explore the methods and clinical value of multi-colored flow cytometry for the detection of small residual lymphocytic leukemia(b-all)in acute B.Method To choose the hospital diagnosed with B-ALL 71 cases of patients as the research object,USES three color to begin with FCM and combination of patients of two groups of six colors antibody immune classification,complete remission(CR)33 d after chemotherapy,3 months,6 months,9 months,a specimen of the bone marrow in 12 months,according to the diagnosis of immune classification,detection of MRD level.Cox regression was used to analyze the factors influencing recurrence.Results(1)Three color and multi-color FCM immunological classification results were compared: the positive rates of CD19,CD20 and CD22 were 65.77%,40.85% and100.00% respectively,respectively,respectively,100.00%,40.85% and 98.59%respectively.The correlation antigen CD5 positive rate was 4.23% in trichromatic FCM and 6.82% for h6.The positive rate of CD13 and CD33 was 22.54% and 35.21%respectively,while the 6-color was 25.35% and 33.80% respectively.The positive rate of CD10 and CD34 was 74.65 %,83.10% and 6 color were 78.87% and 84.51 %.The difference was not statistically significant(P>0.05).(2)Periodic detection of FCM: the proportion of MRD?10-4 in the critical group and high-risk group at 33 d is 82.35% and 62.07%.At 3 months,it was 76.47% and 53.85%,respectively.The six months were 70.59% and 50.00% respectively;At 9 months,55.17%and 45.00% respectively;In 12 months,57.14% and 42.11% respectively,the proportion of MRD?10-4 in the critical group was higher than that in the high-risk group,and the difference was statistically significant(P < 0.05).(3)Relationship between MRD level and recurrence : the 333d63 patients were examined and the recurrence rate of MRD ? 10-4 and MRD< 10-4 was 41.18% and 6.52%respectively.At 3 months,60 patients were examined and the recurrence rate was 35.00%and 0.00% respectively.The recurrence rate was 41.67% and 0.00% respectively.At 9months,49 patients were examined and the recurrence rate was 29.16% and 0.00%respectively.In the 12 months,47 patients were examined and the recurrence rate was13.04% and 0.00% respectively.The recurrence rate of MRD ? 10-4 was higher than that in patients with MRD,and the difference was statistically significant(P < 0.05).Cox regression analysis showed that 33dMRD? 10-4,3-month MRD ? 10-4,high risk stratification and high risk of My expression positive was the risk factor for the relapse of b-all patients(P < 0.05).Conclusion(1)the total number of antibody used in multi-color FCM is relatively small,but it is basically the same as that of trichromatic flow cytometry.Moreover,multiple antigens can be detected in the same test tube with multicolor FCM,and the combination of LAIP adjusted according to the initial diagnosis of immune-typing is beneficial to the MRD level of patients with b-all chemotherapy.(2)The multi-color FCM screening MRD > 10-4 in 3d-3 and 3 months after the chemotherapy relief of b-all patients suggests a recurrence risk increase,which can be used as a means to determine the prognosis,relapse and guide clinical individualized treatment. |
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