检测IgH基因重排残留量在多发性骨髓瘤治疗中的应用价值

The application value of IgH gene rearrangement residues in the treatment of multiple myeloma

目的:探讨采用实时荧光定量PCR(RT-PCR)法检测免疫球蛋白重链(IgH)基因重排残留量在多发性骨髓瘤(MM)治疗中的应用价值。方法:选取近年来江门市人民医院收治的65例MM患者作为研究对象。在这些患者经治疗病情达到临床完全缓解(CCR)后,采用RT-PCR法检测其IgH基因重排残留量,总结检测IgH基因重排残留量在MM治疗中的应用价值。结果:65例患者经6个周期的化疗后,其中病情达到CCR的患者有54例,达到部分缓解(PR)的患者有9例,未缓解(NR)的患者有2例。在经治疗达到CCR的54例患者中,有31例患者的IgH基因重排呈阳性。这31例患者在治疗前及经治疗达到CCR后,其IgH基因重排拷贝数无显著变化(P>0.05),其骨髓瘤细胞的比例有显著变化(P<0.01)。在65例患者中,免疫球蛋白分型为IgG型和IgA型的患者经治疗达到CCR后,其IgH基因重排拷贝数偏高。结论:采用RT-PCR法检测MM患者治疗后的IgH基因重排残留量能指导临床治疗,有助于预防其病情复发,提高其临床疗效。

Objective:To investigate the application value of real-time fluorescence quantitative PCR(RT-PCR)for the detection of immunoglobulin heavy chain(IgH)gene rearrangement residues in the treatment of multiple myeloma(MM).Methods:65 MM patients admitted to Jiangmen People’s Hospital in recent years were selected as the research object.After these patients achieved clinical com plete remission(CCR),RT-PCR was used to detect IgH gene rearrangement residues,and the application value of IgH gene rearrangement residues in MM treatment was summarized.Results:After 6 cycles of chemotherapy,54 patients achieved CCR,9 patients achieved partial response(PR),and 2 patients did not achieve response(NR).Of the 54 patients who achieved CCR,31 were positive for IgH gene rearrangement.In these 31 patients,there was no significant change in IgH gene rearrangement copy number before treatment and after CCR treatment(P>0.05),but significant change in myeloma cell proportion(P<0.01).In 65 patients with IgG and IgA immunoglobulin types,the IgH gene rearrangement copy number was higher after CCR treatment.Conclusion:Using RT-PCR to detect IgH gene rearrangement residues in MM patients after treatment can guide clinical treatment,help to prevent the rec urrence of disease and improve its clinical efficacy.