慢性粒细胞白血病bcr/abl基因检测在造血干细胞移植过程中的临床意义  

Clinical significance of detecting the level of bcr/abl Gene in hematopoietic stem cell transplant of chronic myeloid leukemia

作　　者：万琼[1] 颜金花[1] 邬国和[1] 姚晔[1] 张华[1] 

机构地区：[1]南昌大学医学院第三附属医院,南昌330008

出　　处：《江西医药》2010年第7期649-650,共2页Jiangxi Medical Journal

摘　　要：目的探讨慢性粒细胞白血病(CML)bcr/abl基因检测的临床意义,以及移植后治疗效果及预后监测等方面的价值。了解慢性粒细胞白血病融合基因表达、染色体改变及细胞学的改变与临床诊断和治疗的关系。方法采用实时定量逆转录-聚合酶链反应(RT-PCR)检测15例CML患者移植前、后bcr/abl融合基因的表达;染色体制备采用骨髓短期培养法,G显带,分析核型。结果对照组bcr/abl基因表达、Ph染色体均为阴性;15例患者移植前:bcr/abl基因表达阳性率为100%(15/15),表达量范围4.7×104～3.2×108copies/L;Ph染色体分析结果中,13例为Ph(+)/bcr(+),2例为Ph(-)/bcr(+)。细胞学分析结果 :呈CML的细胞学改变。移植后1个月bcr/abl融合基因转阴率为80%,2个月转阴率达93%,3个月转阴率达100%。Ph染色体均为阴性。另外,0.5～3年内有13%(2/15)的患者bcr/abl基因表达呈阳性,6%(1/15)的患者Ph(+),有复发的阳性指标。结论 bcr/abl基因表达水平的定量检测及动态观察,对CML的临床诊断、移植后疗效判断及预后的监测具有重要意义.Objective To investigate clinical significance of detection of bcr/abl gene,and the value in transplant effect and predicting prognosis.To find out the contact among chronic myeloid leukemia fusion gene expression,chromosome change,cytological changes and clinical diagnosis and treatment.Methods The level of bcr/abl mRNA in bone marrow before and after hematopoietic stem cell transplantation in 15 chronic myeloid leukemia patients was detected by using real time quantitative PCR;chromosome was detected by short-term culture of bone marrow,G-banding and analysis of karyotype.Results bcr /abl gene expression and Ph chromosome were negative in control group.Before transplantation：bcr /abl gene expression rate was 100%（15/15）,scope of the expression was 4.7×104 ～ 3.2×108copies/L;13 patients with Ph（＋）/bcr（＋）,2 cases of Ph（-）/bcr（＋）;cytological changes consistent with CML.1 month after transplantation,bcr /abl fusion gene negative rate was 80%,2 months negative rate was 93%,and 3 months 100%.All Ph chromosome were negative.In addition,0.5 ～ 3 years after transplantation,13% （2 /15）of patients bcr /abl gene were positive,6%（1/15） of patients with Ph （＋）,there were positive indicators of recurrence.Conclusion It is important significance of bcr /ablgene expression quantitative detection and dynamic observation in the clinical diagnosis,effect and predicting prognosis after transplantation of CML.

关 键 词：慢粒移植 BCR/ABL融合基因 FQ-PCR检测 PH染色体 

分 类 号：R733.72[医药卫生—肿瘤]