急性早幼粒细胞性白血病端粒酶活性变化及其临床意义  

Study on the dynamic changes of the telomerase activity and its clinical significance in children with acute promyelocytic leukemia

作　　者：陈静[1] 顾龙君[1] 应大明[1] 潘慈[1] 姚慧玉[1] 薛惠良[1] 卞锦国[1] 赵学军[1] 

机构地区：[1]上海第二医科大学附属新华医院上海儿童医学中心血液科,上海200127

出　　处：《临床儿科杂志》2004年第2期76-78,共3页Journal of Clinical Pediatrics

基　　金：上海市科委回国人员科研启动基金资助项目(编号 :99GJHG05)

摘　　要：目的寻求新的肿瘤监测指标 ,探索端粒酶活性在急性早幼粒细胞性白血病化疗过程中的动态变化 ,并评判酶活性与预后的相关性。方法用TRAPElisaPCR方法对照研究10例早幼粒白血病患者起病初及经全反式维甲酸等治疗诱导缓解后的端粒酶活性 ,并比较肿瘤负荷、年龄、治疗措施及缓解时间对端粒酶活性的影响。结果与正常同龄者相比 ,白血病患者骨髓细胞具有明显增高的端粒酶活性 ;经治疗缓解后 ,患者的端粒酶活性明显下降并几乎恢复正常 ;1例缓解后端粒酶活性仍较明显升高者 ,疾病很快复发 ;单纯维甲酸治疗与维甲酸结合化疗者达到缓解时端粒酶活性无明显差异 ;不同年龄、不同时间达到诱导缓解者端粒酶活性也无明显差异。结论端粒酶活性是急性早幼粒细胞性白血病细胞的普遍标记 ,酶活性强度与肿瘤负荷明显相关 ,端粒酶活性有可能成为监测残留肿瘤细胞、评价治疗效果、预测肿瘤预后的指标。Objective To search for the new markers to monitor the dynamic changes of telomerase happened in the chemotherapy for the patients with acute promyelocytic leukemia(APL)and evaluate the correlation between the activity of this enzyme and the prognosis of the disease.Methods Ten patients with APL were enrolled for the following_up.The telomerase activities were studied with TRAP Elisa PCR method in the initial stage of presentation and after achieving complete remission(CR) with ATRA and other combined chemotherapy respectively.And the impact of the tumor burden,patient's age,therapeutic measures and the duration of CR on telomerase activity were judged.Results In comparison with the normal control group at the same age,the telomerase activities of the marrow blast cells in the patients with leukemia were significantly high.But the telomerase activities remarkably decreased and approached to the normal range when the patients got CR with induction therapy.While the telomerase activity still kept on the higher level in one patient after CR and he relapsed soon.No significant difference could be found on the way to get CR(whether only with ATRA or ATRA combined with chemotherapy),the age and how long they got into CR.Conclusion The results indicated that the intensity of the enzyme activity had close relationship with the tumor burden,so the telomerase activity could be used as the generalized marker for APL cells and might be the potential marker in monitoring the residual tumor cells,evaluating the therapeutic effect and predicting the prognosis of the patients.

关 键 词：急性早幼粒细胞性白血病 端粒酶活性 染色体 肿瘤 化疗 

分 类 号：R733.71[医药卫生—肿瘤]