目的 探討吉西他濱+米托蒽醌+足葉乙甙(GME)方案誘導化學療法(化療)治療復發難治性急性白血病的療效。 方法 2010年5月-2011年4月對20例復發難治性急性白血病應用GME方案化療,以了解其有效性、毒副反應。 結果 隨訪7個月20例復發難治性白血病經過GME方案誘導化療1個療程后總反應率為50%,其中5例完全緩解,4例部分緩解,1例形態學完全緩解而血細胞計數未完全緩解,均無早期死亡患者。 結論 GME方案可作為復發難治性急性髓系白血病的一種安全、有效的誘導化療方案,值得臨床嘗試。
Objective To investigate the value of a 4-color and 10-antibody flow cytometry immunophenotyping panel using 10 antibodies including CD45, CD38, CD19, CD56, CD20, CD5, CD10, human leukocyte antigen-DR (HLA-DR), κ antibody and λ antibody marked by four kinds of fluorescein including R-phycoerythrin (PE), fluorescein isothiocyanate (FITC), peridinin chlorophy Ⅱ protein (PerCP) and allophycocyanin (APC) in the diagnosis of multiple myeloma (MM). Methods A 4-color and 10-antibody flow cytometry immunophenotyping panel which used CD45dim/-/CD38high as gating strategy supplemented by CD19, CD56, CD20, CD10, CD5, HLA-DR, κ antibody and λ antibody was used to test the bone marrow (BM) specimens of 45 MM patients treated between December 2013 and March 2015. Then by morphological examination, we analyzed the quantitative results and characteristics of myeloma cells. Results In all the 45 MM patients, the myeloma cell detection rate was 100% by flow cytometry. The proportion range of myeloma cells in BM was between 1.17% and 72.31%, which showed a good consistency with the results of 7.5%-90.0% detected by morphological examination. The positive expression rates of antigen on myeloma cells were: 100.00% for CD38, 11.11% for CD45, 2.22% for CD19, 73.33% for CD56, 17.78% for CD20, 42.22% for HLA-DR, and 0% for CD10 and CD5. About 64.44% of the MM patients were restricted cytoplasmic λ light chain typing, and 35.56% were restricted cytoplasmic κ light chain typing. There was no obvious phenotype difference among the 3 Durie-Salmon stages of MM (P>0.05). The expression of CD56 was different among different immunoglobulin types of MM, and the types of immunoglobulin with an expression from high to low were non-secretory, IgA, IgG, and light chain (P<0.05). Conclusion The 4-color and 10-antibody flow cytometry immunophenotyping panel using 10 antibodies including CD45, CD38, CD19, CD56, CD20, CD5, CD10, HLA-DR, κ antibody and λ antibody marked by four kinds of fluorescein including PE, FITC, PerCP and APC has a good diagnostic value for MM.