102例儿童急性淋巴细胞性白血病微小残留病的监测及其与临床和预后的关系  

Monitoring of 102 Cases of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia and Its Relationship to Clinic and Prognosis

作　　者：陈启文[1] 黄正刚[1] 张丽娜[1] 占诗贵[1] 袁高乐[1] 刘赟[1] 吴星恒[1] 

机构地区：[1]南昌大学第一附属医院儿科,南昌330006

出　　处：《南昌大学学报（医学版）》2011年第12期39-41,共3页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨儿童急性淋巴细胞性白血病(ALL)微小残留病(MRD)与临床和预后的关系。方法 102例儿童急性B系淋巴细胞性白血病按照ALL-XH-99方案分为低危(low risk,LR)组28例、中危(medium risk,MR)组50例、高危(high risk,HR)组24例。所有患儿均接受ALL-XH-99方案化疗,并随访6～28个月。在诱导治疗结束获CR、化疗6个月时利用CD45/SSC双参数图设门的三色流式细胞术(FCM)进行MRD监测。结果诱导治疗结束获CR及化疗6个月时3组MRD阳性率比较差异有统计学意义(P<0.05或P<0.01),其中HR组MRD阳性率明显高于MR、LR组(P<0.05或P<0.01);MRD阳性者的复发率明显高于MRD阴性者(P<0.05或P<0.001)。结论检测MRD有助于判断儿童ALL的疗效及预后。Objective To explore the relationship of minimal residual disease（MRD） in childhood acute lymphoblastic leukemia（ALL） to the clinic and prognosis.Methods A total of 102 cases of MRD in childhood ALL（28 cases in low-risk group,50 in medium-risk group and 24 in high-risk group）were treated with ALL-XH-99 protocol and were followed-up for 6-28 months.CD45/SSC gating dual-parameter three-color flow cytometry（FCM） was used to monitor MRD in children who achieved CR at the end of induction therapy or at 6 months after initiating chemotherapy.Results There were significant differences in MRD-positive rate among the three groups at the end of induction therapy and at 6 months after initiating chemotherapy（P0.05 and P0.01,respectively）.MRD-positive rate in high-risk group was significantly higher than that in medium-risk group or low-risk group（P0.05 and P0.01）.Moreover,the relapse rate in MRD-positive patients was obviously higher than that in MRD-negative patients（P0.05 and P0.001）.Conclusion The detection of MRD can help to determine the efficacy and prognosis of childhood ALL.

关 键 词：急性淋巴细胞性白血病 微小残留病 预后 复发 儿童 

分 类 号：R733.711[医药卫生—肿瘤]