小儿急性白血病多药耐药基因表达的动态观察及其临床意义

THE CLINICAL SIGNIFICANCE OF MDR1 EXPRESSION IN CHILDREN WITH ACUTE LEUKEMIA

为探讨小儿急性白血病 (AL)多药耐药基因MDR1表达的临床价值 ,检测2 8例AL患者 4 8份标本的MDR1基因 ,并对其中 2 0例患儿进行了动态观察。结果 ,小儿急性白血病在治疗的不同阶段其MDR1的阳性率不同 :化疗前的阳性率为 2 5 % ,MDR1阳性与MDR1阴性患者的完全缓解率 (CR)分别为 33%和 92 % (P <0 .0 1) ,耐药组的阳性率为 80 % ,而非耐药组的阳性率为 16 % (P <0 .0 1)。复发组的MDR1阳性率为 75 % ,而持续缓解组的MDR1阳性率为 16 % (P <0 .0 5 )。正常人MDR1阳性率为零。结果表明检测MDR1对判断化疗效果和估计预后均有很重要的作用 。

To discuss the clinical value of expression of MDR1 in children with acute leukemia patient, expression of MDR1 were measured in 48 samples of 28 ALL patients. 20 of them were also observed continuously. Results showed, the positive rate of MDR1 expression was different in different medical treatment stage in ALL. The rate of MDR1 expression was 25% in initial treating patients. Complete remission rate (33%) was lower in MDR1 positive patients than that (92% P< 0.01) in MDR1 negative patients. The positive rate of MDR1 expression in drug-resistant patients (80%) was higher than that (16% P< 0.01) in none drug-resistant patients. The positive rate of MDR1 expression in reoccurring patients (75%) was also higher than that (16% P< 0.05) in continuous relaxation and none of normal controls. Conclusion The expression of MDR1 can predict the treatment outcome and the prognosis of leukemia patients. The detection of MDR1 can also offer an objective factor in choosing medical treating plan.