目的：采用多参数流式细胞术（FCM）检测急性白血病（AL）患者外周血白血病细胞的数量，为AL的临床疗效及预后提供参考。方法采用FCM检测71例AL患者外周血标本，同时检测骨髓细胞形态学的变化。结果 FCM检测外周血微小残留病变（ MRD）对提示急性髓细胞白血病（ AML）复发的敏感性和特异性分别是96．6％和33．3％，对提示急性淋巴细胞白血病（ ALL）复发的敏感性和特异性分别是88．9％和44．4％；12例外周血MRD阴性组中有3例（25．0％）患者复发，59例外周血MRD阳性组中有44例（74．6％）复发， MRD阳性组复发率明显高于MRD阴性组（ P＜0．05）；高MRD水平（≥10－2）组和低MRD水平（＜10－2）组复发例数分别是37例（97．4％）和10例（47．6％），高MRD水平组复发率明显高于低MRD水平组（P＜0．05）。结论 FCM检测外周血白血病细胞对诊断AL复发及指导个体化治疗有重要意义。%Objective To investigate the amounts of peripheral blood leukemic cells from acute leukemia ( AL ) patients determined by flow cytometry (FCM), in order to provide the reference for clinical efficiency and prognosis . Methods A total of 71 patients with AL were enrolled , and peripheral blood leukemic cells were determined by FCM . The morphological analysis of bone marrow cells was performed .Results The sensitivity and specificity for the diagnosis of acute myeloid leukemia ( AML) relapse by peripheral blood minimal residual disease ( MRD) determined by FCM were 96.6%and 33.3%, and those for the diagnosis of acute lymphocytic leukemia (ALL) relapse were 88.9%and 44.4%.In peripheral blood MRD negative group, there were 3 relapse cases of 12 patients(25.0%), and in peripheral blood MRD positive group , there were 44 relapse cases of 59 patients ( 74.6%).The relapse rate of peripheral blood MRD positive group was significantly higher than that of MRD negative group (P<0.05).The relapse amounts of high MRD level group (≥10 -2) and low MRD level group (<10 -2) were 37 cases(97.4%)and 10 cases (47.6%), and the relapse rate of high MRD level group was significantly higher than that of low MRD level group (P<0.05).Conclusions The peripheral blood leukemic cells determined by FCM has significance for the diagnosis of AL relapse and its treatment .
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