AML1/ETO融合转录子在白血病患者化疗及骨髓移植后的追踪观察

Follow up Detection of AML/ETO Fushion Transcripts after Chemotherapy or Bone Marrow Transplantation in Leukemia Patients

利用逆转录 聚合酶链反应 (RT PCR)技术分别检测 4 9例初治病人及 12例化疗、8例BMT后病人不同时期骨髓细胞AML1/ETOmRNA的表达。结果显示 :①AML1/ETOmRNA可表达于AML M2 ,AML M4及MDS RAEB T中 ;② 9例病人化疗后、5例Allo BMT及 1例Auto PBSCT后RT PCR结果分别转为阴性并处于持续完全缓解状态 ,2例化疗病人由阴性转为阳性而后复发 ,1例化疗病人持续弱阳性后转阳性并复发。 2例Allo BMT病人移植后持续阳性并分别死于复发及GVHD。研究结果提示 ,化疗及骨髓移植可以使RT PCRAML1/ETOmRNA转为阴性 ;由阴性转阳性或持续阳性可能预示复发 。

Expression of AML1/ETO mRNA was observed in bone marrow cells from 49 untreated leukemic patients, and continuously detected during different periods after chemotherapy(12 cases) or bone marrow transplantation(8 cases). The results showed that AML1/ETO mRNA could be expressed in cells from AML M 2, AML M 4 and MDS RAEB T patients. The positive expression changed into negative at different duration in patients who achieved complete remission either by chemotherapy(9 cases), allogeneic bone marrow transplantation(5 cases) and autologous peripheral blood stem cell transplantation(1 case), and they were sustained in complete remission status. In chemotherapeutic group, patients whose AML1/ETO expression turning from negative(2 cases) or faint positive(1 case) to positive relapsed later. Two patients treated with Allo BMT showed continuously positive results and died of GVHD and relapse, respectively. These observations suggest that AML1/ETO chimeric mRNA could disappeared after chemotherapy or bone marrow transplantation. The patients have a great probability to relapse if the results of RT PCR are continuously positive or change from negative to positive. Regular detection is necessary for leukemic patients.