CAJ | 학술논문

目的探讨流式细胞术( FCM)检测急性淋巴细胞白血病B细胞系(ALL-B)患儿骨髓微小残留病( MRD)的临床意义.方法以多种四色荧光标记抗原的FCM对52例ALL-B患儿分别于诱导治疗第33天、化疗3、6个月时检测骨髓MRD,进行长期随访,以后每6个月检测骨髓MRD进行观察.按照疾病危险度分为标危组(SR)、中危组(IR)、高危组(HR).结果化疗6个月时,SR组MRD阳性率19％ (4/21),IR组35％(8/23),HR组63％(5/8).52例ALL-B患儿复发9例,其中SR组2例,IR组4例,HR组3例.结论 MRD水平与疾病复发之间存在一定的关系,是具有重要指导意义的疾病预后因素.应用FCM技术动态定时监测ALL-B患儿MRD对及时调整ALL-B的化疗强度、个体化治疗早期预测复发、选择合适的治疗方法及是否进行骨髓移植具有重要的临床意义.
목적 탐토류식세포술( FCM)검측급성림파세포백혈병B세포계(ALL-B)환인골수미소잔류병( MRD)적림상의의.방법 이다충사색형광표기항원적FCM대52례ALL-B환인분별우유도치료제33천、화료3、6개월시검측골수MRD,진행장기수방,이후매6개월검측골수MRD진행관찰.안조질병위험도분위표위조(SR)、중위조(IR)、고위조(HR).결과 화료6개월시,SR조MRD양성솔19％ (4/21),IR조35％(8/23),HR조63％(5/8).52례ALL-B환인복발9례,기중SR조2례,IR조4례,HR조3례.결론 MRD수평여질병복발지간존재일정적관계,시구유중요지도의의적질병예후인소.응용FCM기술동태정시감측ALL-B환인MRD대급시조정ALL-B적화료강도、개체화치료조기예측복발、선택합괄적치료방법급시부진행골수이식구유중요적림상의의.
Objective To evaluate the clinical significance of minimal residual disease (MRD)detecion in ALL-B of children by flow cytometric (FCM).Methods 52 cases of children with ALL-B were performed bone marrow MRD by FCM analisis after induction therapy,3 moths therapy,and 6 moths therapy.After that,MRD detection was performed every 6 months. According to disease risks, three group were categorized,standard risk (SR),imidiete risk (IR) and high risk(HR).Results After 6 months,SR groups MRD positive cases were 4/21(19 ％),IR groups MRD position cases were 8/23 (35 ％),HR groups MRD position cases were 5/8 (63 ％).9 cases relapsed in all 52 patients.There were significant differrence in replased rate between the positive and negtive MRD (P＜0.001). Conclution The dynamic detection of MRD by FCM can be used to evaluate the therapeutic effect and prognosis of children with ALL-B. It is also useful in adjusting treatment strategy and for following up in children with ALL.