CAJ | 학술논문

目的观察PML-RARα融合基因在监测急性早幼粒细胞白血病(APL)微小残留病(MRD)中的临床意义.方法诱导缓解及巩固维持治疗期间,采用筑巢式反转录-聚合酶链反应(RT-PCR)技术检测患者骨髓细胞中PML-RARα融合基因的动态变化、PML-RARα融合基因.结果长期随访的18例完全缓解(CR)患者,2例出现分子学复发.其中1例发生于CR1后4个月,诱导缓解治疗后获得CR2,CR2后2个月再次出现分子学与血液学的复发,诱导治疗1个疗程获得CR3;1例发生于CR1后74个月,诱导缓解治疗后获得CR2,随访结束时生存期已达106个月.结论在CR期定期监测PML-RARα融合基因,可早期发现分子学复发,及时干预治疗可避免血液学复发.
목적 관찰PML-RARα융합기인재감측급성조유립세포백혈병(APL)미소잔류병(MRD)중적림상의의.방법 유도완해급공고유지치료기간,채용축소식반전록-취합매련반응(RT-PCR)기술검측환자골수세포중PML-RARα융합기인적동태변화、PML-RARα융합기인.결과 장기수방적18례완전완해(CR)환자,2례출현분자학복발.기중1례발생우CR1후4개월,유도완해치료후획득CR2,CR2후2개월재차출현분자학여혈액학적복발,유도치료1개료정획득CR3;1례발생우CR1후74개월,유도완해치료후획득CR2,수방결속시생존기이체106개월.결론 재CR기정기감측PML-RARα융합기인,가조기발현분자학복발,급시간예치료가피면혈액학복발.
Objective To investigate the kinetics of PML-RARα fusion gene in acute promyelocytic leukemia(APL)to monitor minimal residual disease(MRD). Methods In induction therapy,consolidation and maintenance therapy courses, PML-RARα fusion gene was performed by RT-PCR. Results The long-term follow-up of 18 cases achieved complete remission (CR),two cases experienced molecular relapse. One case relapsed at 4 months after CR1 and achieved CR2 after induction therapy. However, molecular and hematology relapsed again at 2 months after CR2 and re-achieved CR3. The other case relapsed at 74 months after CR1 and achieved CR2 after induction treatment, who had survived for 106 months until the end of follow-up. Conclusion RT-PCR assay for detection of PML-RARα should be performed regularly during CR period so as to find molecular relapse eady. Hematological relapse could potentially be averted through treatment modification according to molecular monitoring results of PML-RARα.