免疫球蛋白重链基因指纹图谱分析小儿急性淋巴细胞白血病的克隆性

Analysis of clonality with immunoglobulin heavy chain gene rearrangement fingerprinting map in childhood acute lymphoblastic leukemia

目的：探讨小儿急性淋巴细胞白血病（ＡＬＬ）免疫球蛋白重链（ＩｇＨ）基因重排形式的种类，以及是否存在几个克隆并存的情况。方法：应用多聚酶链反应（ＰＣＲ）和单链构象多态性（ＳＳＣＰ）技术，构建ＩｇＨ－ＰＣＲ－ＳＳＣＰ基因指纹（ｆｉｎｇｅｒｐｒｉｎｔｉｎｇ），分析３４例ＡＬＬ患儿ＩｇＨ基因重排的基因指纹图谱。结果：单克隆的ＩｇＨ基因重排中除了单等位基因重排９例（３２．１４％）外，有１５例（５３．５７％）是双等位基因重排；４例（１４．２９％）白细胞数高、免疫表型是早期Ｂ细胞的病例表现寡克隆性ＩｇＨ重排。结论：从基因水平证实，小儿ＡＬＬ多发生ＩｇＨ双等位基因重排，且有多个克隆并存的现象。

Objective:To investigate the types of the immunoglobulin heavy chain (IgH) gene rearrangement and the co existing clones in childhood acute lymphoblastic leukemia (ALL).Methods:Polymerase chain reaction (PCR) amplification and single strand conformation polymorphism (SSCP) were used to construct the IgH PCR SSCP gene fingerprinting.Results:Of the 34 gene fingerprinting maps obtained from newly diagnosed ALL ,9 (32.14%) were one allelic rearrangement and 15(53.75%) were bi allelic in mono clonal rearrangements.Four cases (14.29%) with high white cell count and precursor B immunophenotype were oligoclonal rearrangements.Conclusion:There were multiple IgH bi allelic rearrangements and co existing clones in childhood ALL.