| Objective:This study detected proportion of leukemia stem cell (LSC) in stem cells and progenitor cells of bone marrow of patients with acute leukemia by flow cytometry, explore its clinical value on judgement of prognosis,evaluation of efficacy and prediction recurrence.Methods:CD34+CD123+ was identified as the main immune phenotype of LSC in this study, CD34+ was identified as the main mark of hematopoietic stem cells and progenitor cells. By the means of flow cytometry,the proportion of CD123+ cells in CD34+ cells(CD34+CD123+/CD34+)were detected to determine the proportion of LSC in the stem cells and progenitor cells in 72 cases of patients with acute leukemia.At the same time, the proportion of CD123+ cells in CD34+ cells(CD34+ CD123+/CD34+)were detected as a negative control in 13 cases of patients without neoplastic hematologic disorder.Results:1, CD34+CD123+/CD34+ ratio of newly diagnosed patients with acute leukemia:①CD34+CD123+/CD34+ ratio of newly diagnosed patients with acute leukemia and negative controls :The ratio of 43 newly diagnosed acute leukemia patients was 38.24%±24.74%, the ratio of 13 cases of negative controls was 1.90%±1.03%, the CD34+CD123+/CD34+ ratio of newly diagnosed acute leukemia patients group was significantly higher than the negative control group (P <0.05).②CD34+CD123+/CD34+ ratio of acute myeloid leukemia and acute lymphocytic leukemia: the ratio of 25 patients with acute myeloid leukemia was 36.35%±24.94%, the ratio of 15 patients with acute lymphocytic leukemia was 40.81%±20.91%, CD34+CD123+/CD34+ ratio showed no significant difference between the two groups (P >0.05). ③CD34+CD123+/CD34+ ratio of different prognosis groups:the ratio of 15 patients with high-risk cytogenetic changes was 59.51%±20.80%, the ratio of 15 patients with standard risk cytogenetic changes was 37.12%±19.00%,13 cases with low-risk cytogenetic changes, the ratio was 14.98%±7.97%. The CD34+CD 123+/CD34+ ratios of high-risk, standard risk, low-risk groups were higher than the negative control group, the difference was significant (P <0.05). High-risk group was significantly higher than the standard risk group and the low risk group, the difference was significant (P <0.05), standard risk group was significantly higher than low-risk group, the difference was statistically significant too(P <0.05). The ratio of 17 patients with high white blood cell was 49.03%±24.58%, the ratio of 26 patients with non-high white blood cell was 31.19%±22.61%, high white blood cell group CD34+CD123+/CD34+ ratio was higher than non-high white blood group (P <0.05).2, CD34+CD123+/CD34+ ratio of patients with acute leukemia in different stages:①CD34+CD123+/CD34+ ratio of the untreated group, the recurrence group, the remission group and control group:the ratio of 43 newly diagnosed acute leukemia patients was 38.24%±24.74%, the ratio of 9 cases of relapsing patients was 40.53%±11.33%, the ratio of 20 cases of patients in remission was 6.14%±2.89%, the ratio of 13 cases of negative controls was 1.90%±1.03%.The difference of CD34+CD123+/CD34+ ratio between newly diagnosed group and the recurrence group was not statistically significant (P>0.05), CD34+CD123+/CD34+ ratio of remission group compared with newly diagnosed group and the recurrence group decreased, the difference was statistically significant (P <0.05), but still higher than the control group (P <0.05).②CD34+CD123+/CD34+ ratio of different stages after remission: analysing CD34+CD123+/CD34+ ratio of three acute leukemia patients from first visit time to different stages after remission,the result showed: CD34+CD123+/CD34+ ratio of first visit time was different from the first day,the 30th day, the 60th day after remission (P<0.05). The difference of CD34+CD123+/CD34+ ratio between the first day,the 30th day and the 60th day after remission was not significant(P>0.05). Conclusions:1, The content of LSC in the stem cells and progenitor cells of newly diagnosed patients was significantly higher than controls, the content of LSC showed no significant difference between acute myeloid leukemia and acute lymphocytic leukemia,the content of LSC decreased from high-risk groups, standard risk group to low-risk group, the content of high white blood cell group was higher than non-high white blood group, suggesting that the content of LSC should be correlated with the prognosis of patients, so to detect the content of LSC has some value in judging the prognosis of patients.2, The content of LSC in the stem cells and progenitor cells of patients in remission decreased obviously compared with newly diagnosed patients, the difference of the content of LSC between different stages after remission was not significant,the content of LSC significantly increased after the recurrence, indicating that to detect content of LSC conduce to evaluating the efficacy and predicting recurrence.
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