CAJ | 학술논문

目的：探讨急性T淋巴细胞白血病（T-ALL）患儿微小残留病（MRD）监测的临床指导价值。方法采用多参数流式细胞术对2006年1月1日-2008年12月31日在北京儿童医院治疗的60例T-ALL患儿在治疗不同时间点进行追踪监测，分析不同MRD水平患儿的临床特征及预后。结果诱导治疗第33 d MRD≥1×10-4组患儿易复发，P＝0.03；诱导治疗第33 d MRD＜1×10-4组患儿预计5年无事件生存率（EFS）为100％，而MRD≥1×10-4组患儿5年EFS为（62.5±7.1）％，两组之间差异有显著性（P＝0.018）。结论监测T-ALL患儿MRD水平在评估早期治疗反应、监测复发以及估计预后中具有重要临床价值。
목적：탐토급성T림파세포백혈병（T-ALL）환인미소잔류병（MRD）감측적림상지도개치。방법채용다삼수류식세포술대2006년1월1일-2008년12월31일재북경인동의원치료적60례T-ALL환인재치료불동시간점진행추종감측，분석불동MRD수평환인적림상특정급예후。결과유도치료제33 d MRD≥1×10-4조환인역복발，P＝0.03；유도치료제33 d MRD＜1×10-4조환인예계5년무사건생존솔（EFS）위100％，이MRD≥1×10-4조환인5년EFS위（62.5±7.1）％，량조지간차이유현저성（P＝0.018）。결론감측T-ALL환인MRD수평재평고조기치료반응、감측복발이급고계예후중구유중요림상개치。
Objective To observe the Clinical significance of minimal residual disease (MRD)in childhood acute T-cell lymphoblastic leukemia (T-ALL).Methods A total of 60 children with T-ALL were enrolled in this study from January 1of 2006 to December 31 of 2008.Their MRD levels were monitored by multiparameter flow cytometry in different therapy time point.The relationship between MRD levels and clinical features and prognosis were analyzed.Results The patients were divided into 2 groups according to the MRD level (MRD≥1 ×10 -4 or MRD <1 ×10 -4 )at the early 33th day of induction therapy.The difference between these two groups was significant in the relapse (P=0.03 ) i.e.patients with MRD≥1 ×10 -4 were more likely to have relapse.The 5-year events-free survival was 100% in the patients with MRD<1 ×10 -4 at the early 33 th day of induction therapy,and the 5-year events-free survival was 62.5% ±7.1% in the patients with MRD≥1 ×10 -4,there was significant between the two groups,P=0.018;the patients with MRD<1 ×10 -4 had better prognosis.Conclusions Sequential monitoring MRD by multiparameter flow cytometry in different therapy time point should evaluate the early response and provide highly significant prognostic information in children with T-ALL.