【摘要】 目的：探究成人急性B淋巴细胞白血病(B-ALL)患者骨髓肿瘤坏死因子-α(TNF-α)水平及其在患者化疗效果及肿瘤复发评估中的作用。方法：前瞻性地收集了107名B-ALL患者(疾病组)、25名健康供者(健康对照组)和77名其他类型血液肿瘤患者(疾病对照组)的外周血和骨髓血浆样本。通过化学发光免疫分析法测定血浆TNF-α浓度；流式细胞术测定缓解和复发患者白血病细胞半乳糖凝集素-9(Gal-9)表达情况；TNF-α与患者原代细胞体外共培养，检测Gal-9表达情况。结果：B-ALL患者骨髓TNF-α水平升高且TNF-α水平与首次化疗缓解情况有关，首次化疗完全缓解者初诊时的骨髓TNF-α浓度较非完全缓解者更低；复发患者白血病细胞Gal-9表达显著上调；TNF-α在体外可诱导Gal-9表达上调。结论：揭示了成人B-ALL患者骨髓及外周血TNF-α水平升高，并诱导白血病细胞Gal-9表达上调促进疾病进展和复发。更多还原

【Abstract】 Objective: This study intends to investigate the levels of bone marrow tumor necrosis factor-alpha(TNF-α) in adult acute B-lymphoblastic leukemia(B-ALL) patients and the role of TNF-α in the efficacy of chemotherapy and tumor recurrence. Methods: Peripheral blood and bone marrow plasma samples were prospectively collected from 107 patients with B-ALL(disease group), 25 healthy donors(healthy controls), and 77 patients with other types of hematologic neoplasms(disease controls). Plasma TNF-α concentration was determined by chemiluminescence immunoassay. Gal-9 expression in leukemia cells from remission and relapse patients was determined by flow cytometry and TNF-α was co-cultured in vitro with primary cells from the patients to detect the changes in the expression of Gal-9. Results: Bone marrow TNF-α levels were elevated in B-ALL patients and TNF-α levels correlate with whether or not they are in remission from the first chemotherapy treatment. Bone marrow TNF-α concentrations at the time of initial diagnosis were lower in the first-time chemotherapy complete remission patients compared to those in non-complete remission patients. The leukemia cell Gal-9 was significantly up-regulated in relapsed patients and TNF-α induced Gal-9 up-regulation in vitro. Conclusions: This study reveals that bone marrow and peripheral blood TNF-α levels are elevated in adult B-ALL patients and induce up-regulation of Gal-9 in leukemia cells to promote disease progression and tumor relapse.更多还原