小儿急性淋巴细胞白血病微量残留病检测的临床研究  

Clinical study of minimal residual disease in childhood acute lymphoblastic leukemia

作　　者：贾月萍[1] 田开功[1] 陆爱东[1] 张乐萍[1] 刘桂兰[1] 

机构地区：[1]北京大学人民医院儿科,100044

出　　处：《中国实用儿科杂志》2003年第4期223-225,共3页Chinese Journal of Practical Pediatrics

摘　　要：目的　探讨小儿急性淋巴细胞白血病 (ALL)微量残留病 (MRD)检测的临床意义 ,进一步了解ALL复发与缓解的生物学特点。方法　分析近 10年来有MRD检测资料的 77例初治ALL ,对其中 4 4例进行动态追踪检测MRD。主要采用聚合酶链反应 (PCR)方法 ,以免疫球蛋白重链和T细胞受体δ基因重排作为肿瘤标志。结果　初治标本PCR检测MRD阳性者和阴性者的复发率差异无显著性意义 (P >0 0 5 )。化疗 3个月时PCR检测转阴的病例复发率明显低于未转阴的病例 (P <0 0 5 ) ,且与临床分型无明显相关性。结论　MRD的动态检测可以作为小儿ALL判断预后的独立因素。PCR法动态监测MRD ,有助于完善白血病分型、判断预后和指导治疗。Objective To determine the clinical significance of tracing minimal residual disease in childhood acute lymphoblastic leukemia and to further understand the biology of relapse and remission of childhood acute lymphoblastic leukemia.Methods A retrospective study of 77 acute lymphoblastic leukemia cases was done during the past ten years.Minimal residual disease was traced successfully in 44 cases by polymerase chain reaction using TCR δ and IgH rearrangement genes as markers.Results Presence or absence of minimal residual disease at diagnosis did not significantly affect outcomes.Continuous presence of minimal residual disease over the first three months of remission predicted relapse and it had no relationship with the clinical classification.Conclusion The monitor of minimal residual disease is the independent prognostic factor in childhood acute lymphoblastic leukemia.It has clinical significance in classification and treatment selection and predicting outcome of acute lymphoblastic leukemia.

关 键 词：小儿 急性淋巴细胞白血病 微量残留病 检测 临床意义 

分 类 号：R733.71[医药卫生—肿瘤]