逆转录酶／聚合酶链反应检测早幼粒细胞白血病PML－RARα融合基因对预后和微量残留白血病细胞检测的意义

DETECTION OF PML-RARα FUSION GENE AND MNMALRESIDUAL LEUKEMC CELLS WITH RT/PCR TO PREDICTTHE PROGNOSIS OF ACUTE PROMYELCOYTICLEUKEMIA

应用逆转录酶／聚合酶链反应（ＲＴ／ＰＣＲ）技术检测９７例中国人急性早幼粒细胞白血病（ＡＰＬ），其中包括３５例初发期患者，４４例缓解期患者，以及１８例进行动态观察的患者，发现二种ＰＭＬ－ＲＡＲα融合ｍＲＮＡ异构体（Ｌ型或Ｓ型）存在于５２例初发期ＡＰＬ中，其早期死亡率和复发率Ｓ型高于Ｌ型，两者预后差异具有统计学意义（Ｐ＜０．０２５）。６２例缓解期患者中有１１例ＰＣＲ阳性，其中５例于检测后１～６个月内复发，６例经强化治疗后仍处缓解期，其中１例化疗２疗程后ＰＣＲ转阴，提示ＲＴ／ＰＣＲ确实为检测微量残留白血病细胞的一项极灵敏方法，可作为预报ＡＰＬ复发的一项指标。

his paper dealt with the transcriptional expression ofthe AML_1-ETO fusion gene transcripts in acute myelogenous leukemia (AML) M_(2b) phenotype with t (8 ;21).We developed a specific “nested” reverse transcriptase/polymerase chain reaction (RT/PCR). This rapid andsensitive method proved useful not only for the diagnosisof AML-M_(2b) subtype, but also for the detection of theminimal residual disease as it might detect one leukemiccell out of 10￣4￣ 10￣5 normal cells during the clinicalremission. Among the 11 AML-M_(2b) patientsinvestigated , PCR amplification products were obtainedin 10 cases while the RT/PCR was negative in one t(8;21) case, suggested possible molecular heterogenicity.The role that the AML-ETO fusion gene played in theleukemogenesis needs further studies.