急性淋巴细胞白血病化疗缓解后TCRγ基因检测的意义

Detection of TCRγ gene in acute lymphoblastic leukemia after remission and its clinical significance

目的：定量检测急性淋巴细胞白血病化疗效应差异及其临床意义。方法：应用竞争性ＰＣＲ技术，定量检测急性淋巴细胞白血病（ＡＬＬ）细胞中Ｔ细胞受体γ（ＴＣＲγ）基因重排。结果：检测ＡＬＬ患者５４例１５８份骨髓标本，随访时间中位数为３３．５个月。临床缓解时３６例患者的白血病细胞＜１×１０－５，１８例为（３５４±３２７）×１０－５。诱导缓解期的杀伤效应与缓解早期的残留白血病细胞数量显著相关，并与临床复发相关。部分患者缓解后残留白血病细胞数量持续小于１×１０－５且临床无复发。结论：白血病化疗效应差异显著。

Objectives: To investigate the quantitative evaluation of chemotherapy efficiency in patients with acute leukemia and its clinical significance. Methods: Clonal rearrangement of T-cell receptor γ gene in ALL was detected quantitatively by using competitive PCR. Results: One hundred and fiftyeight samples were collected from 54 childhood ALL. The median followup duration was 33.5 months. At remission, the amount of leukemic cells in 36 cases was less than 1×10^(-5), and in 18, was (354±327)×10^(-5). The efficiency of induction therapy was related significantly to the amount of the detectable residual leukemic cells in the early remission phase and to clinical relapse. In some patients in remission,the amount of leukemic cells persistently under 1×10^(-5) without clinical relapse. Conclusion: Quantitative evaluation of the chemotherapy efficiency is helpful for individualized treatment. 