老年急性淋巴细胞白血病大剂量甲氨蝶呤治疗患者β_2-MG、CyclinB2水平和IgH基因重排及其临床意义  

The levels of β_2-MG,CyclinB2 and IgH gene rearrangement in elderly patients with acute lymphoblastic leukemia treated with large dose methotrexate and their clinical significance

作　　者：梁月雄[1] 崔翠萍[1] 林璐[1] 黄鹏程[1] 林薇 李冰[1] 

机构地区：[1]广东省肇庆市第一人民医院,广东肇庆526100

出　　处：《中国医药科学》2018年第3期39-41,54,共4页China Medicine And Pharmacy

摘　　要：目的探讨老年急性淋巴细胞白血病大剂量甲氨蝶呤治疗患者β_2-MG、CyclinB2水平和IgH基因重排及其与预后的关系。方法以老年急性淋巴细胞白血病患者36例为研究对象,均采用大剂量甲氨蝶呤[3g/(m^2·d)]治疗,并随访至少1年。采用放射免疫法检测其治疗前的外周血β_2-MG水平,实时定量RTPCR法检测外周血CyclinB2,并采用半巢式PCR方法检测外周血IgH基因重排,统计其随访1年生存率。结果 36例患者1年生存率为80.56%(29/36)。与其存活患者比较,其死亡患者治疗前外周血CyclinB2和β_2-MG水平较高,IGH基因重排阳性率亦较高(P<0.05)。Spearman相关性分析结果显示,老年急性淋巴细胞白血病外周血β_2-MG、CyclinB2水平和IgH基因重排率与其1年生存率均呈负相关(r=-0.844,-0.818,-0.852,P<0.05)。结论老年急性淋巴细胞白血病大剂量甲氨蝶呤治疗患者β_2-MG、CyclinB2水平和IgH基因重排与其预后情况密切相关,且三者联合预测患者预后价值良好,可能作为老年急性淋巴细胞白血病大剂量甲氨蝶呤治疗预后评估参考指标。Objective To investigate the levels of β_2-MG,CyclinB2 and IgH gene rearrangement in elderly patients with acute lymphoblastic leukemia treated with high-dose methotrexate and their relationship with prognosis. Methods Thirty-six elderly patients with acute lymphoblastic leukemia were treated with high-dose methotrexate [3 g/(m^2·d)] and followed up for at least one year.The level of β_2-MG in peripheral blood was detected by radioimmunoassay.The CyclinB2 in peripheral blood was detected by real-time quantitative RT-PCR.The IgH gene rearrangement in peripheral blood was detected by semi nested PCR,and the follow-up 1 years survival rate was statistically analyzed. Results The 1-year survival rate of 36 patients was 80.56%(29/36).Compared with the surviving patients,the levels of CyclinB2 and β_2-MG in the peripheral blood of the patients with death before treatment were higher.The positive rate of IgH gene rearrangement was also higher(P < 0.05).The results of spearman unconditional correlation analysis showed that the levels of β_2-MG,cyclin B2 and IgH gene rearrangement in peripheral blood of elderly patients with acute lymphoblastic leukemia were negatively correlated with their 1-year survival rate(r=-0.844,-0.818,-0.852,P < 0.05). Conclusion The level of β_2-MG,CyclinB2 and IgH gene rearrangement in elderly patients with acute lymphoblastic leukemia are closely related to the prognosis of the patients.And that combination of the three predict the prognosis of the patient with good value,and may be used as a reference index for evaluating the prognosis of acute lymphoblastic leukemia with high dose of methotrexate.

关 键 词：老年 急性淋巴细胞白血病 大剂量 甲氨蝶呤 Β2-MG CyclinB2 IGH 预后 

分 类 号：R733.7[医药卫生—肿瘤]