成人急性淋巴细胞白血病微小残留病的监测

The Monitoring of Minimal Residual Disease in Acute Lymphoblastic Leukemia of Adults

目的建立以免疫球蛋白重链(Immunoglobin heavy chain H,Ig H)及T细胞受体r(T cell receptor r,TCR r)基因重排为基础的微小残留病检测方法,并探讨其在临床应用的前景及意义。方法应用多聚酶链反应(PCR)的方法对74例成人急性淋巴细胞白血病患者进行Ig H及TCR r基因重排的检测及不同时间点的监测。结果两种基因重排联合检测率较单一基因重排高,联合检测持续阳性患者的复发率高于持续阴性患者。结论 Ig H及TCR r基因重排可作为临床监测微小残留病(MRD)指标,联合Ig H及TCR r基因重排的检测方法简便、敏感性高,尤其是动态监测不同时间点MRD更有临床意义。

Objective The aim of this stuy is to establish a method of minimal residual disease using immunoglobulin heavy chain （IgH） gene rearrangement and T cell receptor r （TCR r） gene rearrangement and explore its clinical significance, Methods Detect IgH, TCR r gene rearrangement of 74 acute lymphoblastic leukemia cases by PCR and monitor these gene rearrangements in the different times of chemotherapy. Results The simultaneous monitoring of IgH and TCR r gene rearrangrnent is sensitiver than any single gene rearrangement. The continuous positived patients have a higher relapse rates than those have a negative result. Conclusion The monitoring of immunoglobulin heavy chain gene rearrangement and T cell receptor r gene rearrangement can be used in minimal residual disease. The method of simultaneous monitoring of IgH and TCR r gene rearrangrnent is sensitive and facility in cilinieal application,especially for dynamic monitoring of different times of MRD.