流式细胞术检测急性淋巴细胞白血病B细胞系患儿骨髓微小残留病的临床意义  

Clinical significance of MRD detection in ALL-B of children by FCM

作　　者：郝国平[1] 王晓欢[1] 常虹[1] 史红鱼[1] 程艳丽[1] 朱镭[2] 

机构地区：[1]山西省儿童医院血液科,太原030013 [2]山西省儿童医院分子生物室,太原030013

出　　处：《白血病．淋巴瘤》2012年第7期427-429,共3页Journal of Leukemia & Lymphoma

基　　金：山西省儿童医院院内课题（200705）

摘　　要：目的探讨流式细胞术（FCM）检测急性淋巴细胞白血病B细胞系（ALL—B）患儿骨髓微小残留病（MRD）的临床意义。方法以多种四色荧光标记抗原的FCM对52例ALL—B患儿分别于诱导治疗第33天、化疗3、6个月时检测骨髓MRD，进行长期随访，以后每6个月检测骨髓MRD进行观察。按照疾病危险度分为标危组（SR）、中危组（IR）、高危组（HR）。结果化疗6个月时，SR组MRD阳性率19％（4／21），IR组35％（8／23），HR组63％（5／8）。52例ALL-B患儿复发9例，其中SR组2例，IR组4例，HR组3例。结论MRD水平与疾病复发之间存在一定的关系，是具有重要指导意义的疾病预后因素。应用FCM技术动态定时监测ALL—B患儿MRD对及时调整ALL—B的化疗强度、个体化治疗早期预测复发、选择合适的治疗方法及是否进行骨髓移植具有重要的临床意义。Objective To evaluate the clinical significance of minimal residual disease （MRD）detecion in ALL-B of children by flow cytometric （FCM）. Methods 52 cases of children with ALL-B were performed bone marrow MRD by FCM analisis after induction therapy, 3 moths therapy, and 6 moths therapy. After that, MRD detection was performed every 6 months. According to disease risks, three group were categorized, standard risk （SR）, imidiete risk （IR） and high risk（HR）. Results After 6 mouths, SR groups MRD positive cases were 4/21（19 %）, IR groups MRD position cases were 8/23 （35 %）, HR groups MRD position cases were 5/8 （63 %）. 9 cases relapsed in all 52 patients. There were significant differrenee in replased rate between the positive and negtive MRD （P〈0.001）. Conclution The dynamic detection of MRD by FCM can be used to evaluate the therapeutic effect and prognosis of children with ALL-B. It is also useful in adjusting treatment strategy and for following up in children with ALL.

关 键 词：白血病 双表型 急性 流式细胞术 复发 儿童 微小残留病 

分 类 号：R733.7[医药卫生—肿瘤]