儿童急性髓性白血病M2型AML1/ETO融合mRNA检测及其临床意义  

Detection and clinical significance of AML1/ETO fusion mRNA in children with acute myeloid leukemia type M2

作　　者：陆爱东[1] 张乐萍[1] 刘桂兰[1] 殷慧君[1] 

机构地区：[1]北京大学人民医院儿科,100041

出　　处：《实用儿科临床杂志》2001年第4期187-188,共2页Journal of Applied Clinical Pediatrics

摘　　要：目的　研究AML1/ETO融合mRNA在儿童急性髓性白血病M2型中的表达及其对残留白血病监测及预后的指导意义。方法　通过逆转录酶 /聚合酶链反应 (RT PCR)方法扩增M2型患者的AML1/ETO融合mRNA ,并结合临床资料综合分析。结果　 3 6例AMLM2中 2 7例AML1/ETO融合基因阳性 ,占 75 %;RT PCR方法阳性率明显高于染色体分析 ;AML1/ETO融合基因阳性病人缓解率 ( 74 %)高于阴性病人 ( 5 6%) ;通过AML1/ETO融合mRNA的检测可监测体内残留白血病情况 ,AML1/ETO阳性病人经治疗后转阴并持续阴性者预后好 ;而持续阳性者预后差 ;由阴性转阳性者可预示复发。结论　RT PCR检测AML1/ETO融合mRNA为更敏感的细胞遗传学诊断方法 ,定期检查可以监测体内微小残留白血病 ,为治疗、预后判断提供了有效手段。Objectives To investigate the clinical significance of AML1/ETO fusion mRNA in diagnosing and monitoring of minimal residual disease and its prognostic value.Methods Reverse transcription-polymerase chain reaction(RT-PCR) was used to detect AML1/ETO fusion transcript of 36 AML M2 patients and analyze these combined with clinical manifestations.Results The fusion transcript was detected in 27/36(75 %) AML M2 patients.RT-PCR was much more sensitive than cytogenetic analysis.74 %(20/27) of AML1/ETO-positive patients achieved complete remission after induction,only 56 %(5/9) in AML1/ETO-negaitive patients.Minimal residual disease was detected by RT-PCR amplification.The AML1/ETO-positive patients who became PCR-negative after several courses of chemotherapy had an optimistic outcome,but the patients who demonstrated persistence of AML1/ETO fusion mRNA had a poor prognosis.PCR becoming positive again indicates relapsing.Conclusions RT-PCR amplification of AML1/ETO fusion transcript is a sensitive tool for cytogenetic diagnosis.It provides us effective ways for therapy and prognosis.We can monitor minimal residual disease in AML M2 patients by detecting AML1/ETO fusion mRNA regularly.

关 键 词：急性髓性白血病M2型 逆转录酶-聚合酶链反应 AML1/ETO融合 MRNA 微量残留白血病 儿童 

分 类 号：R733.71[医药卫生—肿瘤]