【摘要】：目的:觀察并研究外周血髓系來(lái)源的抑制性細(xì)胞在B系急性淋巴細(xì)胞白血病(B-ALL)患兒經(jīng)長(zhǎng)春地辛、柔紅霉素、培門(mén)冬酶和強(qiáng)的松(Vindesine、Daunorubicin、Pegaspargase、Prednisone,VDLP)方案化療緩解后的變化并分析其與免疫系統(tǒng)的可能關(guān)系。方法:選取我院2015年8月至2016年8月期間收治的30例經(jīng)VDLP方案化療后緩解的B-ALL患兒為B-ALL組,選取30例正常健康兒童為對(duì)照組,分別抽取2組的外周血,采用流式細(xì)胞術(shù)檢測(cè)并計(jì)算其外周血CD33~+細(xì)胞和CD33~+HLA-DR~-、CD14~+CD33~+HLA-DR~-、CD15~+CD33~+HLA-DR~-骨髓源抑制性細(xì)胞的比例,分析其在B-ALL患兒經(jīng)VDLP方案化療緩解后的變化及其與免疫系統(tǒng)的關(guān)系。結(jié)果:治療后B-ALL組和對(duì)照組外周血CD33~+細(xì)胞比例無(wú)明顯差異(P0.05);治療后B-ALL組外周血患兒CD33~+細(xì)胞比例顯著高于治療前(P0.05)。治療后B-ALL組患兒外周血CD33~+HLA-DR~-、CD14~+CD33~+HLA-DR~-、CD15~+CD33~+HLA-DR~-髓系來(lái)源抑制性細(xì)胞比例均顯著低于對(duì)照組健康兒童(P=0.02,P=0.02,P=0.04)。治療后B-ALL組患兒外周血CD33~+HLA-DR~-、CD14~+CD33~+HLA-DR~-、CD15~+CD33~+HLA-DR~-骨髓源抑制性細(xì)胞比例均高于治療前,但差異均無(wú)統(tǒng)計(jì)學(xué)意義(均P0.05)。結(jié)論:外周血骨髓源的抑制性細(xì)胞在B-ALL患兒行VDLP方案化療后完全緩解期比例高于治療前,顯著低于正常值,這可能與化療后患兒免疫系統(tǒng)還未完全恢復(fù)有關(guān)。
[Abstract]:Objective: To observe and study the changes of the suppressor cells derived from peripheral blood myeloid in B system acute lymphoblastic leukemia (B-ALL) children with Changchun digoxin, daunorubicin, aspartate and Jodison (Vindesine, Daunorubicin, Pegaspargase, Prednisone, VDLP) and to analyze the possible relationship with the immune system. In our hospital from August 2015 to August 2016, 30 children with B-ALL after VDLP chemotherapy were treated as B-ALL group. 30 normal healthy children were selected as the control group. 2 groups of peripheral blood were extracted respectively. Flow cytometry was used to detect and calculate the peripheral blood CD33~+ cells and CD33~+ HLA-DR~-, CD14~+CD33~+HLA-DR~-, CD15~+CD33~+HLA-DR~-. The ratio of bone marrow suppressor cells was analyzed, and the relationship between the changes in the VDLP regimen and the immune system in children with B-ALL was analyzed. Results: there was no significant difference in the proportion of CD33~+ cells in the peripheral blood of the B-ALL group and the control group after treatment (P0.05), and the proportion of CD33~+ cells in the peripheral blood of the B-ALL group was significantly higher than that before the treatment (P0.05). The percentage of peripheral blood CD33~+HLA-DR~-, CD14~+CD33~+HLA-DR~-, and CD15~+CD33~+HLA-DR~- in the B-ALL group was significantly lower than that in the control group (P=0.02, P=0.02, P=0.04). The percentage of the peripheral blood CD33~+HLA-DR~-, CD14~+CD33~+HLA-DR~-, and CD15~+CD33~+HLA-DR~- myelogenous cells in the peripheral blood of the group B-ALL was higher than that of the group B-ALL. Before treatment, the difference was not statistically significant (all P0.05). Conclusion: the proportion of peripheral blood bone marrow suppressor cells in B-ALL children's complete remission stage after VDLP regimen was higher than that before the treatment, significantly lower than the normal value, which may be related to the incomplete recovery of the immune system after chemotherapy.
【作者單位】： 南京醫(yī)科大學(xué)附屬兒童醫(yī)院血液腫瘤科;南京大學(xué)附屬鼓樓醫(yī)院血液科;
【分類(lèi)號(hào)】：R733.71

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