69例急性白血病患儿白血病干细胞CD96分子的表达及临床意义

CD96 expression on leukemia stem cells in 69 children with acute leukemia

摘要:

目的：检测急性白血病患儿白血病干细胞（LSC）的表面分子CD96的表达，并分析其临床意义。方法：分离骨髓中单个核细胞，在此基础上采用分选型流式细胞仪分离CD34⁺CD38^-CD123⁺的LSC进行培养，采用检测型流式细胞仪检测69例初治急性白血病患儿LSC表面分子CD96的表达，利用R显带技术检测69例患儿染色体核型，收集患儿血常规，检测免疫相关指标等资料。结果：CD96主要在急性髓系白血病（AML）中表达，在急性淋巴细胞白血病（ALL）中也有少量表达，二者之间的表达差异有统计学意义（P<0.05）。维吾尔族患儿CD96的中位表达含量23.4%，汉族患儿CD96的中位表达含量21.2%，表达量在两民族之间差异无统计学意义（P>0.05）。CD96⁺患儿多伴有预后不良的染色体核型。CD96⁺患儿初次化疗完全缓解率低于CD96^-患儿，而化疗后感染率及复发率明显高于CD96^-患儿，差异有统计学意义（P<0.05）。结论：急性白血病LSC表面CD96表达阳性的患儿预后欠佳，CD96分子可能是判断急性白血病预后的一个新型指标。

Abstract:

OBJECTIVE: To detect the expression of surface molecule CD96 on stem cell (LSC) in children with acute leukemia, and to explore its clinical significance. METHODS: Bone marrow mononuclear cells were isolated in 69 children with newly diagnosed acute leukemia. CD34⁺CD38^-CD123⁺ LSCs were separated from these cells by flow cytometry (FCM) and then cultured, and CD96 expression on LSCs was detected by FCM. R-banding technique was used to analyze the karyotypes of the 69 children, and the data of their routine blood and immunological tests were collected. RESULTS: CD96 was mainly expressed in children with acute myelogenous leukemia, and expressed to a lesser extent in those with acute lymphoblastic leukemia (P<0.05). The median expression level of CD96 in Uyghur children was 23.4%, versus 21.2% in Han children (P>0.05). The majority of children with CD96^-positive children presented poor-prognosis karyotypes. Compared with CD96^-negative children, children with CD96^-positive children had a significantly lower complete remission rate (P<0.05) and significantly higher infection and relapse rates after chemotherapy (P<0.05).  CONCLUSIONS: Children with acute leukemia who have CD96^-positive LSCs have a poor prognosis. CD96 may be a new indicator of prognosis in children with acute leukemia.