急性早幼粒细胞白血病基因分析

Study on conversion of RARα/PML fusion gene in acute promyelocytic leukemia

目的：分析急性早幼粒细胞白血病（ＡＰＬ）患者经全反式维甲酸（ＡＴＲＡ）联合细胞毒药物及异基因骨髓移植（ａｌｏ－ＢＭＴ）治疗后融合基因的变化。方法：采用逆转录－多聚酶链反应（ＲＴ－ＰＣＲ）对２２例ＡＰＬ患者治疗前后ＲＡＲα／ＰＭＬ融合基因进行检测。其中１２例患者为单纯化疗，１０例接受了ａｌｏ－ＢＭＴ，９例患者于第１次完全缓解（ＣＲ１）期、１例于第１次复发（ＲＲ１）期接受了ａｌｏ－ＢＭＴ。结果：单纯维甲酸诱导完全缓解时，７５％ＡＰＬ患者融合基因仍然阳性；继用强化疗后８３％患者融合基因转为阴性，ＲＴ－ＰＣＲ转阴时间为发病后１～３９个月；ａｌｏ－ＢＭＴ后４个月内及４个月后，分别有６２．５％及８５．７％患者融合基因转阴。结论：化疗及ＢＭＴ均可使患者融合基因转阴。

Objective:To analyze the conversion of RARα/PML gene in acute promyelocytic leukemia (APL) patients before and after treatment with all trans retinoic acid (ATRA) followed by intensive consolidation chemotherapy(ICC) and allogeneic bone marrow transplantation (allo BMT).Methods:RARα/PML fusion gene was detected in 22 APL patients before and after treatment by reverse transcriptase polymerase chain reaction (RT PCR).Results:RARα/PML fusion gene was positive in 75% of the patients after achieving complete remission with ATRA,and turned negative in 83% of the patients after ICC.The durations of conversion to the RT PCR negative status varied from 1 to 39 months.Ten patients received allo BMT,and all of them were RARα/PML fusion gene negative in 4 months post allo BMT.Conclusion:APL patients could achieve biological remission after ICC and allo BMT,and the latter seemed to eliminate residual leukemic cells sooner in vivo than the former did.