bcr—abl mRNA检测在慢性粒细胞白血病诊治中的意义

Clinical significance of detection of bcr-abl mRNA in chronic myeloid leukemia

目的探讨bcr—abl mRNA在慢性粒细胞白血病（CML）诊断、治疗及微小残留病变监测中的意义。方法采用实时定量聚合酶链反应（real—time PCR）方法检测324例CML患者518份标本的bcr—abl mRNA表达情况。结果CML慢性期、加速期和急变期患者的bcr-abl mRNA定量结果逐渐增高，分别为12．6％、25．4％和57．2％（P〈0．05）。异基因造血干细胞移植后的bcr—abl mRNA定量结果随时间延长逐渐降低，一般在移植6个月后转阴，服用伊马替尼（商品名：格列卫）与异基因造血干细胞移植病程相似，但融合基因转阴所用时间较长。结论real—time PCR检测bcr—abl mRNA对于诊断、评价疗效、监测微小残留病变以及预测疾病进展具有重要的临床应用价值。

Objective To evaluate significance of the quantification of bcr-abl mRNA in diagnosis and therapy of chronic myeloid leukemia （CML）, essentiality significance for monitoring minimal residual disease. Methods Bcr-abl mRNA of 518 CML patients were detected using real-time PCR. Results Expression of bcr-abl mRNA was gradually increased among blastic phase （BP） （12.6 %）, accelerated phase （AP） （25.4 %） and chronic phase （CP） （57.2 %） （P〈0.05）. Quantification of ber-abl mRNA was cut down gradually after allotransplantation in the patients and becomes normal after treatment for 6 months. But quantification of ber-abl mRNA inpatients treated with imatinib mesylate became normal after 12 months. Conclusion Real-time PCR was reliable and can be used for diagnosis, monitoring the treatment outcome, detecting the minimal residual disease, and predicting blast crisis,