Ph染色体与bcr/abl融合基因的检测在CML中的临床意义  

CLINICAL SIGNIFICANCE OF Ph CHROMOSOME AND bcr/abl FUSION GENE IN CHRONIC MYELOGENOUS LEUKEMIA

作　　者：欧阳敏[1] 刘茂发[2] 

机构地区：[1]江西省人民医院,江西南昌330006 [2]江西医学院一附院,江西南昌330006

出　　处：《白血病．淋巴瘤》2001年第4期224-227,共4页Journal of Leukemia & Lymphoma

摘　　要：目的 :观察 Ph染色体、bcr/ abl融合基因与慢性粒细胞白血病 (CML)诊断、疗效、预后的关系。方法 :用姬姆萨 G带显带法和反转录筑巢式聚合酶链反应 (RT- nest- PCR)对 41例初、复治 CML 患者的骨髓标本进行了分析。将 Ph染色体及 bcr/ abl融合基因均为阳性的慢性期患者随机分成二组 ,分别以干扰素 - α(IFN- α)、羟基脲 (HU)及乌苯美司 (Bestatin、BS)、HU治疗 ,6月后复查核型及 bcr/ abl融合基因。结果 :41例病例中 36例 Ph染色体及 bcr/ abl融合基因均为阳性 ,Ph—、bcr/ abl+ 5例 ,其中 b3a2 转录本 2 9例 ,b2 a2 转录本 12例 ;在可评价的 2 0例病例中 ,两个治疗组各 10例 ,IFN- α治疗组全部达 CHR,2例获得部分细胞遗传学反应 (PGR) ,5例获微小细胞遗传学反应 (Mi GR) ;3例无细胞遗传学反应 ;BS治疗组全部达 CHR,6例达 Mi GR;全部病例均未获分子生物学反应 ;二组治疗均使 CML 获 Ph染色体量的下降 (P<0 .0 1) ,二组病例下降程度无差异 (P>0 .0 5 )。结论 :Ph染色体及 bcr/ abl融合基因均为 CML 重要的诊断指标 ,二者相结合意义更大 ;Ph染色体的量及其变化可判断疗效及预后 ;干扰素及乌苯美司治疗组均取得较好疗效 ,均能使患者获细胞遗传学反应 ,其细胞遗传学疗效无明显差别。Objective:To investigate the value of the detection of Ph chromosome and bcr/abl fusion gene in the diagnosis?treatment and prognosis in chronic myelogenous leukemia (CML).Methods:Forty one patients were studied,and those with Ph chromosome positive and bcr/abl fusion gene positive chronic phase chronic myeloid leukemia were divided into two groups at random.One group were treated with Hu and bestatin and the another were treated with Hu and IFN α.Marrow samples from them were analyzed by G banding technique and RT nest PCR method six months later.Rusults:1)Ph chromosome and bcr/abl fusion gene were both positive in 36 and Ph bcr/abl +in 5.b 3a 2 type was detected in 29 and b 3a 2 type was deteted in 12.2)In IFN α group,all got CHR.Among them,two got partial cytogenetic remission (PCR) and four got minor cytogenetic remission(MiCR).All cases got CHR in bestatin group,in which 6 got MiCR.3)None got molecular biology response in both groups.4)Cytogenetic response can be detected in both groups and there is no difference between the two groups.Conclusion:1)Both Ph chromosome and bcr/abl fusion gene were important figures in diagnosis of CML and combining both is more evaluable. 2)The change of Ph chromosome reflect the effect of treatment and its prognosis. 3)Both groups can get cytogenetic response( P <0.01).There is no apparent statistical difference detween the two groups( P >0.05).

关 键 词：PH染色体 BCR/ABL融合基因 CML 干扰素-Α 乌苯美司 慢性白血病 

分 类 号：R733.72[医药卫生—肿瘤] R730.45[医药卫生—临床医学]