TEL-AML1融合基因的表达与儿童急性淋巴细胞白血病的疗效及预后相关性研究  

Expression of TEL-AML1 fusion gene in children with acute lymphoblastic leukemia and its effect on the clinical efficacy and prognosis

作　　者：谢淑佩[1] 段炤[1] 陈媛媛[1] 梁昌达[1] 

机构地区：[1]江西省儿童医院血液科,江西南昌330006

出　　处：《海南医学》2012年第22期4-6,共3页Hainan Medical Journal

基　　金：江西省卫生厅普通科技计划(编号:20123143)

摘　　要：目的研究TEL-AML1融合基因在儿童急性淋巴细胞白血病(ALL)中的表达情况,探讨该融合基因对其疗效及预后的影响。方法选取200例ALL患儿作为研究对象,分析TEL/AML1、E2A/PBX1、m-BCR/ABL、AF4/MLL四种融合基因的表达情况,并分为TEL/AML1+组(44例)与TEL/AML1-组(135例),比较两组患儿细胞抗原、年龄、白细胞计数、诱导化疗缓解、病死率及中枢侵犯等情况。结果 TEL/AML1+表达均为B细胞系,共计44例,占22.0%,14例E2A/PBX1阳性(7.0%),5例AF4/MLL阳性(2.5%),2例m-BCR/ABL阳性(1.0%)。TEL-AML+组患儿CD13与CD20的表达与TEL-AML-组患儿存在显著性差异(P<0.05),具有统计学意义,其他抗原表达未见与阴性组有显著差异。TEL-AML1+组患儿与TEL-AML1-组患儿比较,白细胞计数低于20×109/L,短期治疗达CR比例更高,而死亡率及中枢神经侵犯比例更低,提示TEL-AML1+组患儿危险程度明显低于阴性组。结论 TEL/AML1融合基因在儿童急性淋巴细胞型白血病中较为常见,尤其是B细胞性ALL,其阳性表达是预后较好的标志之一。Objective To study the expression of TEL-AML1 fusion gene in children with acute lymphoblastic leukemia （ALL）, and its effect on the clinical efficacy and prognosis. Methods Reverse transcription and polymerase chain reaction was applied to detect the expression of four fusion genes （TEL/AML1, E2A/PBX1, BCR/ABL and AF4/MLL） in 200 children with ALL. Based on the expression of TEL/AML1, the patients were divided into two groups： TEL/AML1＋ group and TEL/AML1- group. Comparison was made in terms of the immunological characteristics, age, white cell count, prognosis between two groups. Results Of the 200 children, 44 （22.0%） were TEL-AML1 positive, 14 （7.0%） were E2A/PBX1 positive, 5 （2.5%） were AF4/MLL positive, and 2 （1.0%） were m-BCR/ABL positive. In TEL-AML1＋ group, the positive rate of CD13 was significantly higher than that in TEL-AML1-group （P0.05）, while the positive rate of CD20 was significantly lower （P0.05）. Besides, TEL/AML1＋ group has better prognosis in terms of high complete remission rate and low white cell count. Conclusion TEL/AML1 fusion gene is the most common molecular aberration in childhood ALL, especially in B cell lymphoblastic leukemia, and positive patients show better prognosis.

关 键 词：TEL-AML1融合基因 儿童 急性淋巴细胞型白血病 

分 类 号：R725.5[医药卫生—儿科]