探究动态监测急性T淋巴细胞白血病微小残留病灶的临床意义  

Clinical significance of dynamic monitoring of minimal residual disease in acute T lymphoblastic leukemia

作　　者：赵晓燕[1] 郭晓珺[1] 汪江平[2] 李园[1] 吴学勤[3] ZHAO Xiaoyan GUO Xiaoj un WANG Jiangping LI guan WU Xueqin(iDepartment of Hematology, the First Hospital of Jiaxing City, Jiaxing, 314000, China Department of Paediatrics, Shunde Women and Children＇s Hospital Affiliated to Jinan Uni versity Department of Paediatrics, the First Hospital of Jiaxing City)

机构地区：[1]浙江省嘉兴市第一医院血液科,浙江嘉兴314000 [2]暨南大学附属顺德妇儿医院儿科 [3]浙江省嘉兴市第一医院儿科

出　　处：《临床血液学杂志》2016年第5期744-747,共4页Journal of Clinical Hematology

摘　　要：目的:探究微小残留病灶(MRD)动态监测在急性T淋巴细胞白血病(T-ALL)中的应用及意义。方法:选取48例T-ALL患儿作为研究对象,追踪监测其不同治疗时间节点的MRD水平,同时进行5年或以上的跟踪随访,分析其临床特征和预后特点,评估患儿3年和5年后的累积生存率,并绘制生存曲线。结果:在诱导治疗后第35天,MRD水平≥1×10^(-4)的患儿,其完全缓解率远低于MRD水平<1×10^(-4)的患儿,成功缓解后的复发率也显著高于后者,组间比较差异有统计学意义(P<0.05);从远期疗效来看,首次诱导化疗获得完全缓解且MRD<1×10^(-4)的患儿3年和5年生存率分别为82.5%和71.2%,而首次化疗获得完全或部分缓解且MRD≥1×10^(-4)的患儿3年和5年生存率分别为34.5%和9.1%,组间比较差异有统计学意义(P<0.05)。结论:动态监测MRD水平对T-ALL患儿的复发预测,治疗方案调整及预后判断等具有重要的临床价值。Objective：To explore the application and significance of dynamic monitoring of minimal residual disease（MRD）in acute T lymphoblastic leukemia（T-ALL）.Method：We choose 48 children with T-ALL as research subjects,tracked and monitored their MRD levels in different treatment time,and carried out the follow up for 5 years or more.Then we analyzed the clinical features and prognosis of patients,evaluated cumulative survival rate of 3 years and 5 years and draw survival curve.Result：Thirty-five days after induction therapy,in the children＇s MRD level was higher than or equal to 1×10^-4,the complete remission rate was much lower than that of the children with MRD level below 1×10^-4,and the recurrence rate after successful remission of the former group was also significantly higher than that of the latter group.There was significant difference between the two groups（P〈0.05）.For the long term effect,the 3 and 5 year survival rates were 82.5% and 71.2%,respectively,with a significant difference between the two groups（P〈0.05）.Conclusion：Dynamic monitoring of MRD levels has important clinical value in predicting the recurrence of T-ALL and the adjustment of treatment plan and prognosis.

关 键 词：微小残留病灶 T淋巴细胞 无事件生存率 

分 类 号：R733.7[医药卫生—肿瘤]