伴有6;9染色体易位急性髓系白血病患者DEK-CAN融合基因表达分析

Analysis of DEK-CAN Fusion Gene Expression in Acute Myeloid Leukemia Patients with 6;9 Chromosome Translocation

本研究旨在探讨急性髓系白血病(AML)患者6;9染色体易位与DEK-CAN融合基因表达之间的关系及临床意义。患者骨髓细胞短期培养后按常规方法制备染色体,采用R显带技术进行染色体核型分析。用逆转录巢式聚合酶链反应(RT-nest-PCR)对4例AML患者的骨髓或外周血单个核细胞DEK-CAN融合基因表达进行了分析,并对其中3例行异体骨髓移植(allo-BMT)患者进行动态随访。结果表明:4例急性髓系白血病患者为t(6;9)(p23;q34)易位;4例初诊、再发及完全缓解期患者均不同程度检出DEK-CAN融合基因,占100%;其中初诊、再发期表达明显增强,完全缓解期减弱;3例患者allo-BMT后1-24个月均表达DEK-CANmRNA。临床资料显示4例AML患者中2例于CR后1-24个月复发(其中1例接受异体骨髓移植)、死亡,其余2例完全缓解,在治疗中先后接受异体骨髓移植,现仍然生存。结论:DEK-CAN基因是AML发病的分子基础,检测DEK-CAN融合基因对于AML的诊断、疗效观察及预后判断有重要意义。

This study was aimed to explore the relationship of 6 ;9 chromosome translocation with DEK-CAN fusion gene expression in patients with acute myeloid leukemia （AML） and its clinical significance. Chromosome specimens were prepared by routine method after short-term culture of bone marrow cells; karyotype analysis was performed by R banding technique; the expression of fusion gene DEK-CAN was analyzed by RT-nested-PCR in mononuclear cells of bone marrow or peripheral blood of 4 AML patients, for 3 patients received allo-BMT out of 4 patients the dynamic follow-up was performed. The results indicated that t（6;9）（ p23 ;q34） was confirmed by chromosome karyotype analysis in the four AML patients. The DEK-CAN fusion gene was found during in all four de novo, relapsed and CR patients （ 100% ）. And the expression of DEK-CAN fusion gene enhanced apparently in de novo and relapsed patients, and weakened in CR patient. DEK-CAN mRNA was found in the three patients during 1 - 24 months after allo-BMT. Clinical data showed 2 patients relapsed and died after CR for 1-24 months; the other two patients received allo-BMT got CR and still survive. It is concluded that DEK-CAN fusion gene is the molecular basis in pathogenesis of AML. The detection of DEK-CAN fusion gene is significant for diagnosis of AML, evaluation of curative effect, and predication of prognosis.