白血病·淋巴瘤
白血病·淋巴瘤
백혈병·림파류
JOURNAL OF LEUKEMIA & LYMPHOMA
2012年
4期
199-202
,共4页
霍菲菲%刘欣%孙自敏%朱薇波%孙余婕%郑昌成%吴竞生%蔡晓燕%韩永胜%杨会志
霍菲菲%劉訢%孫自敏%硃薇波%孫餘婕%鄭昌成%吳競生%蔡曉燕%韓永勝%楊會誌
곽비비%류흔%손자민%주미파%손여첩%정창성%오경생%채효연%한영성%양회지
白血病,髓样,慢性%微小残留病%实时定量聚合酶链反应
白血病,髓樣,慢性%微小殘留病%實時定量聚閤酶鏈反應
백혈병,수양,만성%미소잔류병%실시정량취합매련반응
Leukemia,myeloid,chronic%Minimal residual disease%Real-time quantitative PCR
目的 建立慢性粒细胞白血病(CML)实时荧光定量聚合酶链反应(RQ-PCR)检测方法,并研究应用此方法检测CML治疗后微小残留病(MRD)的意义.方法 应用RQ-PCR对80例CML患者初诊时和(或)治疗后的骨髓标本进行分析,检测bcr-abl融合基因的转录水平,回顾性分析临床资料,根据治疗方案不同分为异基因造血干细胞移植组(34例)、甲磺酸伊马替尼组(33例)、羟基脲组(13例),监测 CML患者治疗前后bcr-abl融合基因变化.结果 初诊CML患者bcr-abl阳性平均值为6847.67拷贝/万个细胞,加速期平均值为306 176.08拷贝/万个细胞；异基因造血干细胞移植组移植后1个月平均值为944.33拷贝/万个细胞,移植后6个月平均值2.37拷贝/万个细胞,移植后12个月平均值0.29拷贝/万个细胞,移植后24个月检测不到bcr-abl融合基因；甲磺酸伊马替尼组服用3个月后平均值3720.23拷贝/万个细胞,服用12个月＜0.10拷贝/万个细胞；羟基脲组用药0个月平均值7290.11拷贝/万个细胞,服用9个月后平均值3143.24拷贝/万个细胞.异基因造血干细胞移植组、甲磺酸伊马替尼组相同时间bcr-abl水平差异无统计学意义(t=1.74,P=0.17),羟基脲组与前两组间比较差异有统计学意义(t=3.74,P=0.01；t=2.97,P=0.02).疾病进展时可检测到bcr-abl转录水平的上升；加速期患者的转录本水平明显高于慢性期患者.结论 RQ-PCR作为CML治疗后MRD检测的方法,可以评价治疗效果,预测疾病复发,指导早期进行干预治疗.
目的 建立慢性粒細胞白血病(CML)實時熒光定量聚閤酶鏈反應(RQ-PCR)檢測方法,併研究應用此方法檢測CML治療後微小殘留病(MRD)的意義.方法 應用RQ-PCR對80例CML患者初診時和(或)治療後的骨髓標本進行分析,檢測bcr-abl融閤基因的轉錄水平,迴顧性分析臨床資料,根據治療方案不同分為異基因造血榦細胞移植組(34例)、甲磺痠伊馬替尼組(33例)、羥基脲組(13例),鑑測 CML患者治療前後bcr-abl融閤基因變化.結果 初診CML患者bcr-abl暘性平均值為6847.67拷貝/萬箇細胞,加速期平均值為306 176.08拷貝/萬箇細胞；異基因造血榦細胞移植組移植後1箇月平均值為944.33拷貝/萬箇細胞,移植後6箇月平均值2.37拷貝/萬箇細胞,移植後12箇月平均值0.29拷貝/萬箇細胞,移植後24箇月檢測不到bcr-abl融閤基因；甲磺痠伊馬替尼組服用3箇月後平均值3720.23拷貝/萬箇細胞,服用12箇月＜0.10拷貝/萬箇細胞；羥基脲組用藥0箇月平均值7290.11拷貝/萬箇細胞,服用9箇月後平均值3143.24拷貝/萬箇細胞.異基因造血榦細胞移植組、甲磺痠伊馬替尼組相同時間bcr-abl水平差異無統計學意義(t=1.74,P=0.17),羥基脲組與前兩組間比較差異有統計學意義(t=3.74,P=0.01；t=2.97,P=0.02).疾病進展時可檢測到bcr-abl轉錄水平的上升；加速期患者的轉錄本水平明顯高于慢性期患者.結論 RQ-PCR作為CML治療後MRD檢測的方法,可以評價治療效果,預測疾病複髮,指導早期進行榦預治療.
목적 건립만성립세포백혈병(CML)실시형광정량취합매련반응(RQ-PCR)검측방법,병연구응용차방법검측CML치료후미소잔류병(MRD)적의의.방법 응용RQ-PCR대80례CML환자초진시화(혹)치료후적골수표본진행분석,검측bcr-abl융합기인적전록수평,회고성분석림상자료,근거치료방안불동분위이기인조혈간세포이식조(34례)、갑광산이마체니조(33례)、간기뇨조(13례),감측 CML환자치료전후bcr-abl융합기인변화.결과 초진CML환자bcr-abl양성평균치위6847.67고패/만개세포,가속기평균치위306 176.08고패/만개세포；이기인조혈간세포이식조이식후1개월평균치위944.33고패/만개세포,이식후6개월평균치2.37고패/만개세포,이식후12개월평균치0.29고패/만개세포,이식후24개월검측불도bcr-abl융합기인；갑광산이마체니조복용3개월후평균치3720.23고패/만개세포,복용12개월＜0.10고패/만개세포；간기뇨조용약0개월평균치7290.11고패/만개세포,복용9개월후평균치3143.24고패/만개세포.이기인조혈간세포이식조、갑광산이마체니조상동시간bcr-abl수평차이무통계학의의(t=1.74,P=0.17),간기뇨조여전량조간비교차이유통계학의의(t=3.74,P=0.01；t=2.97,P=0.02).질병진전시가검측도bcr-abl전록수평적상승；가속기환자적전록본수평명현고우만성기환자.결론 RQ-PCR작위CML치료후MRD검측적방법,가이평개치료효과,예측질병복발,지도조기진행간예치료.
Objective To set up a real-time quantitative PCR approach for detection and quantification for bcr-abl transcripts in CML patients,and detect minimal residual disease (MRD) in CML by real-time quantitative PCR (RQ-PCR)and evaluate the significance of MRD detection.Methods The ber-abl.fusion gene expression in 80 patients with CML was analyzed by RQ-PCR. The patients were divided into three groups according to the different treatment, allogeneic hematopoietic stem cell transplantation group,imatinib group and hydroxyurea group. The change of bcr-abl fusion gene was monitored in CML patients before and after treatment.Results The average of RQ-PCR detection on newly diagnosed patients with CML in chronic phase was 6847.67 copies / 104 cells,the accelerated phase was 306 176.08 copies / 104 cells,and the average results were 944.33, 2.37, 0.29, 0 copies / 104 cells after allogeneic hematopoietic stem cell transplantation one month,6 months,12 months or 24 months respectively.The average of RQ-PCR detection after use imatinib mesylate 3 months was 3720.23 copies / 104 cells and not be detected after one year. The average was 7290.11 and 3143.24 copies / 104 cells after hydroxyurea treatment 0 and 9 months respectively.The difference in first two groups was not significant (t=1.74,P=0.17), but the difference between the third group and the first two groups was significant (t=3.74,P=0.01.t=2.97,P=0.02). The upregulation of bcr-abl transcript levels could be detected when disease progression. The transcripts level in accelerated phase was significantly higher than that in chronic phase. Conclusion RQ-PCR can be used to detect the MRD,monitor the treatment outcome,predict disease recurrence and give early intervention.
