急性髓系白血病患者AMLl-ETO融合基因动态监测及分析

Dynamic monitoring and analysis of AML1.ETO fusion gene in acute myeloid leukemia

目的总结分析急性髓系白血病（AML）患者AMLl-ETO融合基因表达水平的动态变化及动态监测的临床价值。方法选择2008年12月至2012年12月濮阳市人民医院收治的20例急性髓系白血病患者为研究对象，均经药物化疗进行诱导缓解、巩固治疗，在初诊时、诱导化疗结束时、复发时分别采集骨髓标本，利用RQ．PCR方法监测AMLl-ETO融合基因的表达水平，总结分析AMLl-ETO融合基因的表达水平与临床参数之间的相关性。结果20例患者在初诊时监测AMLl-ETO表达水平在160％～650％，AMLl-ETO表达水平与骨髓幼稚细胞比、性别、粘连、白细胞、血小板以及血红蛋白均无显著相关性（P〉0．05）。20例患者诱导结束时获得12份骨髓样本，AMLl-ETO表达水平在130％-210％。随访中7例在巩固化疗之后血液学缓解，AMLl．ETO表达水平下降至10．2水平；3例在巩固化疗结束后3个月时经骨髓细胞形态学诊断为复发，AMLl-ETO表达水平在300％～400％，经DA化疗方案化疗后完全缓解；2例患者持续未缓解，其AMLl-ETO表达水平在410％以上，且染色体高度异常改变。结论AMLl-ETO融合基因的表达水平直接与病情有密切关系，动态监测AMLl-ETO融合基因的表达水平对疾病分子水平诊断和疗效判断均有重要指导价值。

Objective To investigate the clinical value of dynamic monitoring and analysis of AML1-ETO fusion gene on acute myeloid leukemia. Methods Twenty patients with acute myeloid leukemia in the people＇ s hospital of Puy- ang from December 2008 to December 2012 were selected as study group and treated by drugs chemotherapy for relieve andconsolidating treatment. The bone marrow samples were selected at the time of first visiting, at the end of the induction chemotherapy, relapse respectively. RQ -polymerase chain reaction （PCR） was used to monitor AML1-ETO fusion gene expression level. AML1 - ETO fusion gene expression level and the correlation between clinical parameters were summarized and analyzed. Results Twenty patients in the firstly diagnosed of AML1-ETO expression level were between 160% -650%. No significant correlation can be seen between AML1- ETO expression levels and bone marrow cells, gender, adhesion, the leukocytes, platelets and hemoglobin （ P 〉 0. 05）. Twelve bone marrow samples were collected at the end of 20 patients were induced and the expression level of AML1-ETO vary from 130% to 210%. Seven cases in follow-up after consolidation chemotherapy in hematological remis- sion and the expression level of AML1-ETO decreased to the level of 10-2. Three cases were diagnosed as recurrence after 3 months at the end of consolidation chemotherapy after bone marrow cell morphology and the expression level of AML1- ETO range was 300% -400%. The 3 cases completely relieved after the DA chemotherapy; 2 cases sustained no response, its expression level of AML1-ETO was more than 410% and the chromosome changed abnormally. Conclusions The expres- sion level of AML1-ETO fusion gene in acute myeloid leukemia patients and disease are closely related, and dynamic moni- toring of AML1-ETO fusion gene expression level has important guiding value on the disease diagnosis in molecular level and efficacy judgment.