儿童急性淋巴细胞性白血病MRL与mdr1基因表达动态监测  

Dynamic detection of MRL and mdr 1 gene expression in children with acute lymphoblastic leukemia

作　　者：周东风[1] 孟浦[1] 林雯[1] 张志泉 刘勤 肖燕[1] 金润铭[1] 费洪宝[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院儿科

出　　处：《华中医学杂志》2002年第2期63-64,66,共3页Central China Medical Journal

基　　金：国家自然科学基金资助项目 (NO .3 9470 786)

摘　　要：目的　探讨儿童急性淋巴细胞性白血病 (ALL)中 ,微小残留白血病 (MRL)与mdr 1基因表达动态监测的临床意义。方法　对 35例ALL患儿不同病期骨髓标本进行PCR或巢式PCR检测IgH和TCRVδ2 Dδ3 基因重排 ,同时应用半定量RT PCR检测mdr 1基因表达。结果　随着完全缓解期延续 ,IgH或 /和Vδ2 Dδ3 基因重排检出率逐渐下降 ,而mdr 1基因阳性表达检出率增加 ,IgH或 /和Vδ2 Dδ3 基因重排持续检测阳性或mdr 1表达水平增高者易复发。结论　动态监测MRL和mdr 1基因表达可判断疗效和预知复发 ,且较一次单独检测更为重要。当IgH或 /和Vδ2 Dδ3 转阴后检测mdrObjective To investigate the clinical implication of dynamic detection of minimal residual leukemia (MRL) and mdr 1 gene expression in children with acute lymphoblastic leukemia (ALL).Methods PCR and nested PCR techniques were used to amplify IgH and (or) TCR Vδ 2Dδ 3 rearrangement fragments from blast cels in bone marrow in 35 cases of ALL, mdr 1 gene expression was detected by RT PCR at the same time.Results With the lapse of CR period, the positive rate of IgH and (or) Vδ 2Dδ 3 showed a decending tendency, but the positive rate of mdr 1 gene expression showed a ascending tendency.The patients with IgH and (or) Vδ 2Dδ 3 being persistent positive or mdr 1 gene expression levels being higher!were easy to relapse.Conclusion Dynamic detection of MRL and mdr 1 gene expression might play a more important role in guiding clinical treatment, evaluating the chemotherapeutic effectiveness and predicting replase than a single detection.While IgH and (or) Vδ 2Dδ 3 turned negative, mdr 1 gene expression could be a supplementary indicator of predicting relapse.

关 键 词：微小残留白血病 多药耐药基因 聚合酶链反应 基因表达 动态监测 急性淋巴细胞性白血病 

分 类 号：R733.7[医药卫生—肿瘤]