| Objective:Flow cytometry was used to detect CD59~-level and FLAER~-cell ratio in peripheral blood cells of patients with acute myeloid leukemia(AML)and to explore its clinical significance.Methods:161 patients with acute myeloid leukemia were divided into acute promyelocytic leukemia group(M3 group)and non-acute promyelocytic leukemia group(non-M3group).Flow cytometry was used to detect the CD59~-level and FLAER~-cell ratio of primordial cells and monocytes,granulocytes in peripheral blood of patients with AML,the first time treatment and complete remission(CR),and compared with the relevant clinical indicators,analyzed the correlativity,and explore its clinical significance.Results:1.161 patients with acute myeloid leukemia were classified according to FAB criteria.There were 18 patients with the first time treatment of M3,42 patients with CR M3,4 patients with the first time treatment of M2,4 patients with CR M2,34patients with the first time treatment of M4,18 patients with CR M4,28 patients with the first time treatment of M5 and 13 patients with CR M5.Among the M3 patients,the average ratio of CD59~-cells in primordial cells was72.96±26.36%in 18 patients with the first time treatment.The average ratio of CD59~-cells in monocytes was 21.20±19.94%in 42 CR patients.The average ratio of CD59~-cells in granulocytes was 17.08±12.89%in 42 CR patients.The average ratio of FLAER~-cells in primordial cells was 62.66±39.98%in 18 patients with the first time treatment.The average ratio of FLAER~-cells in monocytes was 17.36±17.18%in 42 CR patients.The average ratio of FLAER~-cells in granulocytes was 15.20±14.00%in 42 CR patients.Among the non-M3 patients,The average ratio of CD59~-cells in primordial cells was 41.47±27.49%in 66 patients with the first time treatment.The average ratio of CD59~-cells in monocytes was 21.88±19.22%in 35 CR patients.The average ratio of CD59~-cells in granulocytes was 16.33±14.33%in 35 CR patients.The average ratio of FLAER~-cells in primordial cells was 33.69±32.93%in 66 patients with the first time treatment.The average ratio of FLAER~-cells in monocytes was 11.61±11.10%in 35 CR patients.The average ratio of FLAER~-cells in granulocytes was 2.59±2.15%in 35 CR patients.The average ratio of CD59~-cells in primordial cells in 18 M3 patients with the first time treatment(72.96±26.36%)was significantly higher than that of non-M3patients(41.47±27.49%)with statistical significance(p<0.05).The average ratio of FLAER~-cells in primordial cells of in 18 M3 patients with the first time treatment(62.66±39.98%)was significantly higher than that of non-M3 patients(33.69±32.93%)with statistical significance(p<0.05).The average ratio of CD59~-cells in primordial cells in 18 M3 patients with the first time treatment(72.96±26.36%)was significantly higher than that of monocytes(21.20±19.94%)and granulocytes(17.08±12.89%)in CR M3 patients,the difference was significant(p<0.05).The average ratio of FLAER~-cells in primordial cells in 18 M3 patients with the first time treatment(62.66±39.98%)was significantly higher than that of monocytes(17.36±17.18%)and granulocytes(15.20±14.00%),the difference was significant(p<0.05).The average ratio of CD59~-cells in primordial cells in 66 non-M3 patients with the first time treatment(41.47±27.49%)was significantly higher than that of monocytes(21.88±19.22%)and granulocytes(16.33±14.33%)in CR non-M3patients,the difference was significant(p<0.05).The average ratio of FLAER~-cells in primordial cells in 66 non-M3 patients with the first time treatment(33.69±32.93%)was significantly higher than that of monocytes(11.61±11.10%)and granulocytes(2.59±2.15%),the difference was significant(p<0.05).2.The CD59~-level and FLAER~-cell ratio of peripheral blood primordial cells in AML patients the first time treatment were compared with gender,age,WBC at first diagnosis,platelet at first diagnosis(PLT),the primordial cells ratio of peripheral blood,CR rate,prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB),D-dimer(D-D),lactate dehydrogenase(LDH)and other clinical related indexes.The correlation analysis showed that the average CD59~-level in peripheral blood primordial cells of M3patients the first time treatment was positively correlated with the primordial cells ratio of peripheral blood(r=0.660,p=0.003).3.The non-M3 patients with the first time treatment were divided into two groups:CD59~->10%group and CD59~-?10%group.The gender,age,WBC at first diagnosis,PLT at first diagnosis,the primordial cells ratio of peripheral blood,CR rate,PT,APTT,TT,FIB,D-D and LDH were compared between the two groups.The results showed that the CD59~->10%group was higher than the CD59~-?10%group in D-D and LDH,the difference was statistically significant(p<0.05).There were no significant differences in gender,age,WBC at first diagnosis,PLT at first diagnosis,the primordial cells ratio of peripheral blood,CR rate,PT,APTT,TT and FIB between the two groups(p>0.05).The non-M3 patients with the first time treatment were divided into two groups:FLAER~->3%group and FLAER~-?3%group.The gender,age,WBC at first diagnosis,PLT at first diagnosis,the primordial cells ratio of peripheral blood,CR rate,PT,APTT,TT,FIB,D-D and LDH were compared between the two groups.The results showed that the FLAER~->3%group was higher than the FLAER~-?3%group in D-D and LDH,the difference was statistically significant(p<0.05).There were no significant differences in gender,age,WBC at first diagnosis,PLT at first diagnosis,the primordial cells ratio of peripheral blood,CR rate,PT,APTT,TT and FIB between the two groups(p>0.05).Conclusions:1.The levels of CD59~-and FLAER~-PNH clones in peripheral blood cells of AML patients rised in different degrees.2.The levels of CD59~-and FLAER~-PNH clones in peripheral blood cells of AML patients after CR were lower than those at first treatment.3.The average ratio of CD59~-cells in the primordial cells of M3 patients with the first time treatment was positively correlated with the primordial cells ratio of peripheral blood(r=0.660,p=0.003),suggesting that the CD59~-cells is related to the clonal proliferation of leukemia cells.4.The elevated levels of CD59~-and FLAER~-PNH clones in peripheral blood cells of AML patients the first time treatment may be related to coagulation dysfunction in AML patients. |
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