Objective: To establish 10-color fluorescent antibody combination panels for the detection of minimal residual disease (MRD) of acute myeloid leukemia (AML) in our laboratory and discuss the value of clinical application.
Methods: According to the antigen expression characteristics of leukemia cells of incipient AML patients, MRD in bone marrow were detected by multiparameter flow cytometry, and the test results were compared with both bone marrow cell morphology and PCR results, then 10-color fluorescent antibody combination panels in our lab for MRD detection was determined.
Results: The immunophenotypic characteristics of 392 incipient patients with AML in the First Affiliated Hospital of Zhengzhou University were analyzed, among them 357 (91.07%) cases showed abnormal immunophenotypes, which mainly included cross-lineage expression, cross-stage expression, deficiency of antigen expression or abnormal antigen intensity and other abnormal expression. The 10-color fluorescent antibody combination panels established according to abnormal immunophenotypic characteristics of leukemia cells were applied for detecting MRD in 156 patients with AML, the positive rate (43.6%) was higher than 26.8% of morphology, and the results were highly consistent with PCR detection results (96.49%), moreover, the recurrence rate of MRD positive patients (86.96%) was significantly higher than 5.75% of MRD negative patients. Therefore, this method could truly reflect the load of leukemia cells and prompt change of disease condition.
Conclusion: Multiparameter flow cytometry can detect various abnormal immunophenotypes of AML. The 10-color fluorescent antibody combination panels in our lab based on the characteristics of antigens expression in leukemia cells can well detect MRD of leukemia cells, so as to predict relapse and provide basis for clinical treatment.
题目: 急性髓系白血病微小残留病的多色流式细胞术检测.
目的: 建立本实验室急性髓系白血病微小残留病检测的十色抗体组合方案，探讨其临床应用价值.
方法: 根据初发急性髓系白血病患者白血病细胞的抗原表达特征，采用多参数流式细胞术检测骨髓微小残留病，并将检测结果与骨髓细胞形态学和PCR结果进行比较，确定本实验室微小残留病检测的十色抗体组合方案.
结果: 分析郑州大学第一附属医院392例初诊急性髓系白血病患者的免疫表型特点，其中出现异常免疫表型的有357例（占91.07%）。异常免疫表型主要有跨系表达、跨阶段表达、抗原表达缺失或强度异常、其他异常表达。根据白血病细胞异常免疫表型特征建立的本实验室十色抗体组合方案应用于156例急性髓系白血病患者的微小残留病检测，阳性率（43.6%）高于骨髓细胞形态学（26.8%），与PCR检测结果符合度高（96.49%），且阳性者复发率（86.96%）显著高于阴性者（5.75%），可真实反映体内白血病负荷，提示病情变化.
结论: 多参数流式细胞术可检测出急性髓系白血病的多种异常免疫表型，根据白血病细胞抗原表达特点建立的本实验室十色抗体组合方案能很好地检测白血病微小残留病，预测复发.
Keywords: acute myeloid leukemia; immunophenotype; minimal residual disease; multiparameter flow cytometry.