儿童TCF3-PBX1^+急性淋巴细胞白血病中微小残留病与预后的相关性  

The Correlation of Minimal Residual Disease with Prognosis in TCF3-PBX1+Acute Lymphoblastic Leukemia in Children

作　　者：张丽 邹尧 艾晓非 曹增 陈玉梅 郭晔 杨文钰 陈晓娟 王书春 刘晓明 阮敏 刘天峰 刘芳 戚本泉 常丽贤 安文彬 任媛媛 李庆华 竺晓凡 ZHANG Li;ZOU Yao;AI Xiao-Fei;CAO Zeng;CHEN Yu-Mei;GUO Ye;YANG Wen-Yu;CHEN Xiao-Juan;WANG Shu-Chun;LIU Xiao-Ming;RUAN Min;LIU Tian-Feng;LIU Fang;QI Ben-Quan;CHANG Li-Xian;AN Wen-Bin;REN Yuan-Yuan;LI Qing-Hua;ZHU Xiao-Fan(State Key Laboratory of Experimental Hematology,National Clinical Research Center for Blood Diseases,Institute of Hematology&Blood Diseases Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Tianjin 300020,China)

机构地区：[1]中国医学科学院血液病医院(中国医学科学院血液学研究所),实验血液学国家重点实验室,国家血液系统疾病临床医学研究中心,天津300020

出　　处：《中国实验血液学杂志》2020年第6期1831-1836,共6页Journal of Experimental Hematology

摘　　要：目的:评价流式细胞仪(FCM)和逆转录-聚合酶链反应(PCR)2种方法检测TCF3-PBX1+ALL微小残留病(minimal residual disease,MRD)的一致性,并评估这2种监测MRD的方法在儿童预后评价中的价值。方法:选取2008年4月到2015年4月本院收治的TCF3-PBX1+ALL患者55例,采用PCR和FCM 2种方法对55例患者的239份骨髓标本进行MRD分析。所有数据均采用SPSS软件version 16.0进行统计分析。结果:55例儿童TCF3-PBX1+ALL中,男性30例,女性25例;中位年龄5(1-14)岁。随访过程中20例复发。应用PCR和FCM进行MRD检测的结果显示,2种方法之间有较强的相关性(K=0.774,P<0.001)。在诱导治疗d 15和d 33时,PCR+和PCR-的2组患者相比,5年DFS和OS的差异均无统计学意义。在诱导治疗d 33时,FCM-(<0.01%)和FCM+(≥0.01%)2组患者的5年DFS率分别为63.9%±7.0%和0(P<0.01);5年OS率分别为66.5%±7.9%和0(P<0.01)。结合FCM和PCR的MRD监测结果,诱导治疗d 33时,FCM-/PCR-组和单阳性组(FCM+/PCR-和FCM-/PCR+)5年DFS率分别为65.4%±7.2%和25.0%±15.3%(P<0.01)。结论:TCF3-PBX1+ALL中,FCM和PCR的MRD检测结果具有良好的一致性。诱导治疗结束(d 33)FCM检测MRD+提示复发风险高。Objective:To investigate the consistency between FCM and PCR on the detecting of MRD in TCF3-PBX1+ALL,and to investigate the prognosis value of these 2 methods.Methods:55 cases of paediatric TCF3-PBX1+ALL patients from April 2008 to April 2015 were enrolled and analyzed.The FCM and PCR was used to detect the MRD in 239 bone marrow samples of 55 patients.All statistical analyses were carried out by using SPSS software version 16.Results:Among the 55 children with TCF3-PBX1+ALL,there were 30 male and 25 female.The median age was 5(1-14)years.20 patients relapsed during follow-up.The MRD results from PCR and FCM showed a strong correlation between both methods(K=0.774,P<0.001).There was no significant difference in 5-years DFS and OS between the patients in PCR+and PCR-groups on day 15 or day 33.The 5 year DFS rate between the patients in FCM-and FCM+was 63.9%±7.0%and 0;the 5 year OS rate was 66.5%±7.9%and 0.Combined with the result of FCM and PCR,at the d 33 of treatment,the 5-year DFS rate in FCM-/PCR-and single positive group was 65.4%±7.2%and 25.0%±15.3%(P<0.01).Conclusion:The detection result of MRD in TCF3-PBX1 detect by FCM and PCR shows better consistency.MRD positivity detected by FCM at the end of induction therapy(day 33)predicts a high risk of relapse in TCF3-PBX1 ALL patients.

关 键 词：儿童 RT-PCR 流式细胞术 TCF3-PBX1 急性淋巴细胞白血病 

分 类 号：R733.71[医药卫生—肿瘤]