急性淋巴细胞白血病微量残留病的PCR监测  

MONITORING OF MINIMAL RESIDUAL DISEASE IN ACUTE LYMPHOBLASTIC LEUKEMIA BY NESTEDPRIMERS POLYMERASE CHAIN REACTION

作　　者：雷炜[1] 谷仁凯[1] 卢洁[1] 董增义[1] 

机构地区：[1]青岛医学院

出　　处：《青岛医学院学报》1997年第4期296-298,共3页Acta Academiae Medicinae Qingdao Universitatis

基　　金：青岛市科委资助

摘　　要：①目的探讨急性淋巴细胞白血病（ＡＬＬ）微量残留病（ＭＲＤ）检测的临床意义。②方法应用筑巢式多聚酶链反应（ｎｅｓｔｅｄＰＣＲ）对３２例ＡＬＬ进行Ｔ细胞受体（ＴＣＲ）Ｖδ２Ｄδ３基因重排检测。③结果１８例Ｂ系ＡＬＬ中有１５例（７２．２％）、４例Ｔ系ＡＬＬ中有１例（２５．０％）存在ＴＣＲＶδ２Ｄδ３基因重排。同时对１６例进行３９例次微量残留病动态监测，其中６例ＭＲＤ－ＰＣＲ阴性病人随访５．１７～１６．１７年，无１例复发；１０例ＭＲＤ－ＰＣＲ阳性者，２例分别于阳性后０．２５，１．００年骨髓复发，１例有复发倾向，余７例随访４．３３～６．２５年无复发。④结论ＭＲＤ－ＰＣＲ阴性者预后良好，可望长期生存，治疗时应以ＭＲＤ－ＰＣＲ转阴为停止化疗的可靠指标，对ＭＲＤ－ＰＣＲ阳性者应定期监测ＭＲＤ变化，结合病人情况进行综合评价。Objective To investigate the significance of serial monitoring of minimal residual disease (MRD) in patients with acute lymphoblastic leukemia (ALL). Methods Bone marrow samples of 32 patients were examined using nested polymerase chain reaction (PCR) for detecting Vδ2Dδ3 rearrangement of T cell receptor (TCR) gene. Results Fifteen out of 18 B cell ALL patient(72.2%) and 1 out of 4 T cell ALL patients(25.0%) showed Vδ2Dδ3 gene rearrangement. Sixteen out of 39 cases were detected for MRD. The six MRDPCR negative patients remained long term complete remission (CR) (range 5.17 to 16.17 years). Among the ten MRDPCR positive patients, seven patients remained CR for a long term (range 4.33 to 6.25 years), two patients had bone marrow relapse at three and twelve months after MRD detection. Three cases had central nervous system leukemia (CNSL) or testicular leukemia (TL) without remarkable relationship with PCR results. Conclusion The negative MRDPCR indicate a better outcome and should be regarded as an index of ceasing chemotherapy. The exist of detectable MRD is not sufficent to assure the impending relapse and require periodically monitoring with PCR and other valuable strategy.

关 键 词：白血病 淋巴细胞性 微量残留病 急性 PCR 

分 类 号：R733.71[医药卫生—肿瘤]