急性淋巴细胞白血病微小残留病的检测及临床意义

DETECTION OF MINIMAL RESIDUAL DIS-EASE IN CHILDHOOD ACUTE LYM-PHOBLASTIC LEUKEMIA AFIER TERMI-NATION OF THERAPY

采用ＩｇＨ和ＴｃＲｙ基因重排两个标志相结合的方法，通过聚合酶链反应（ＰＣＲ）检测微小残留病（ＭＲＤ）。１８例急性淋巴细胞白血病（ＡＬＬ）患儿在终止治疗后有９例检出ＭＲＤ。受检病例在检测后随访１．５～１０２个月，结果９例ＭＲＤ阳性者有３例于３～６个月内复发；而ＭＲＤ阴性的９例无１例复发，提示治疗终止后仍存在ＭＲＤ者以后有复发的危险，应进行定期监测；ＭＲＤ阴性可作为临床停药观察的一个客观指标。该方法检测ＭＲＤ简便、阳性率较高，适于临床应用。

ith the IgH and TCRγ gene rearrangements asgene markers,we detected minimal residual disease(MRD) by means of polymerase chain reaction(PCR ). Of 18 cases with childhood acute lymphoblas-tic leukernia,9 patients had MRDs after completion oftherapy, All patients had been followed-up for 1.5 to102 months since detection.Three out of the 9 MRD-positive patients relapsed within 3 to 6 months; How-ever,no one among the 9 MRD-negative cases re-lapsed. These results suggested that the patients withMRD after cessation of therapy should be monitoredperiodically for future relapses,and that the “MRD-negative”might be a useful objective indicator for end-ing therapy. The method we used to detect MRD inthis study was simple,convenient and sensitive,hencesuitable for clinical examination.