白血病细胞来源微粒BCR-ABLmRNA检测在监测慢性髓性白血病治疗反应中的意义  

Detection of leukemia-derived microoarticles in the monitoring of chronic myeloid leukemia

作　　者：朱晓健[1] 李青[1] 曾辰[1] 仲照东[1] 游泳[1] 邹萍[1] 

机构地区：[1]武汉华中科技大学同济医学院附属协和医院血液病学研究所,430022

出　　处：《中华血液学杂志》2014年第2期138-141,共4页Chinese Journal of Hematology

基　　金：国家自然科学基金（81170498）

摘　　要：目的探讨通过检测白血病细胞来源微粒（Me）BCR-ABL融合基因水平对达完全分子学反应（cMR）后慢性髓性白血病（CML）患者进行分层的可能。方法收集29例不同疾病状态的CML患者，采用实时定量PCR方法分别检测患者外周血细胞与MP中的BCR-ABLmRNA水平。结果患者外周血MP和细胞中均能稳定检测出BCR-ABLmRNA；CMR、主要分子学反应（MMR）、完全细胞遗传学反应（CCyR）三种疾病状态下患者MP中的BCR-ABLmRNA水平分别为9．1±2．8、25．2±4-6．9和62．8±6-3，差异具有统计学意义（P〈0．05）；细胞内BCR-ABL转录本为阴性时，来源于同一份样本的MP仍可检测到BCR．ABLmRNA[中位水平6．5（3．7～15．3）]；CMR患者MP中BCR—ABL融合基因水平与服药时间呈负相关（t=0．656，P〈0．05）；在同样达到CMR的前提下，造血干细胞移植组患者和酪氨酸激酶抑制剂治疗组患者相比，MP中BCR．ABLmRNA水平更低（分别为3．3±2．1和9．14±2．8，P〈0．05）。结论CML患者外周血细胞来源MP中可以稳定检出BCR-ABLmRNA，并有望成为患者达CMR后继续监测的重要指标。Objective To exam the role of leukemia cells-derived microparticles in the post- complete molecular response stratification. Methods Blood samples from 29 patients diagnosed with chronic myeloid leukemia （CML） were collected. Microparticles （MP） were extracted from the peripheral blood. Real-time PCR was performed to measure the level of BCR-ABL mRNA. Results BCR-ABL mRNA could be stably detected both in MP and peripheral blood cells; BCR-ABL in MP showed significant difference within complete molecular response, major molecular response and complete cytogenetic response （9.1~2.8,25.2~6.9 and 62.8~6.3 respectively, P 〈0.05）. BCR-ABL was detected in MP even when it was negative in peripheral blood cells （3.7-15.3）. For patients with complete molecular response, BCR-ABL in MP but not cells were significantly different between imatinib and stem cell transplant recipients （3.3~2.1 vs 9.1 ~2.8, P 〈0.05）. Conclusion This study indicated that MP may serves as a new target for monitoring of CML. Quantification of BCR-ABL in MP may offer a novel strategy for Stratification of molecular response.

关 键 词：融合蛋白类 BCR-ABL 细胞源性微粒 白血病 髓系 慢性 BCR-ABL阳性 实时聚合酶链反应 

分 类 号：R733.7[医药卫生—肿瘤]