慢性髓性白血病异基因造血干细胞移植后M-bcr/abl及m-bcr/abl融合转录子追踪观察  

Follow-up Detection of M-bcr/abl and m-bcr/abl Fusion Transcripts in Chronic Myeloid Leukemia Patients after Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：秦亚溱[1] 刘艳荣[1] 李金兰[1] 付家瑜[1] 常艳[1] 阮国瑞[1] 王卉[1] 丘镜滢[1] 陆道培[1] 陈珊珊[1] 

机构地区：[1]北京大学人民医院血液病研究所,北京100044

出　　处：《中国实验血液学杂志》2003年第4期368-371,共4页Journal of Experimental Hematology

摘　　要：为研究慢性髓性白血病 (CML)异基因造血干细胞移植 (SCT)后M bcr/abl及m bcr/abl融合转录子表达特征 ,采用逆转录 聚合酶链反应 (RT PCR)技术测定 72例CML患者SCT后不同时间骨髓M bcr/abl及m bcr/abl融合转录子的表达。结果显示 ,CML患者移植后 <6个月M bcr/abl阳性率 (79.2 % ,4 2 /5 3)显著高于 6 - 12个月(34.3% ,11/32 )及≥ 12个月 (35 .1% ,13/37) (P <0 .0 0 1) ,各时间段M bcr/abl阳性患者的临床复发率分别为1 9% (1/5 3) ,0 (0 /32 )及 16 .2 % (6 /37) ;6例临床复发患者中有 5例复发时M bcr/abl与m bcr/abl同时阳性。 14例遗传学缓解患者移植 6个月后M bcr/abl阳性的 17份标本无 1例m bcr/abl阳性。结论 :多数CML患者移植后M bcr/abl仍为阳性 ,一般在 6个月内转阴 ,移植后M bcr/abl阳性的患者不一定复发 ,同时追踪观察M bcr/abl及m bcr/abl融合转录子可能会有助于监测残存白血病。In order to investigate the features of M bcr/abl and m bcr/abl fusion transcripts in patients with chronic myeloid leukemia (CML) after allogeneic stem cell transplantation (SCT), M bcr/abl and m bcr/abl fusion transcripts were sequentially detected by RT PCR technique in 72 CML patients after SCT. The results showed that M bcr/abl positive rate (79.2%, 42/53) within 6 months after SCT was remarkably higher than that in 6-12 months group (34.3%, 11/32) and ≥12 months group (35.1%, 13/37) (P<0.001), and the clinical relapse rates in corresponding periods were 1.9% (1/53), 0%(0/32) and 16.2%(6/37) respectively. M bcr/abl and m bcr/abl fusion transcripts occurred in 5 of 6 clinically relapsed patients. In period of more than 6 months after transplantation, none of 17 M bcr/abl + samples from 14 patients in cytogenetic remission appeared positive reaction of m bcr/abl. It is concluded that M bcr/abl + fusion transcript still existed in most patients after SCT, and usually disappeared within 6 months. Existence of M bcr/abl is not a clinical relapse marker in CML patients. Simultaneous detection of M bcr/abl and m bcr/abl fusion transcripts can be helpful for monitoring residual disease.

关 键 词：慢性髓性白血病 异基因造血干细胞移植 M—bcr/abl融合转录子 m—bcr/abl融合转录子 

分 类 号：R733.72[医药卫生—肿瘤] R457.7[医药卫生—临床医学]