【摘要】 目的　观察bcr/abl融合基因在老年白血病的表达及其临床意义。　 方法 　应用逆转录聚合酶链反应 (RT PCR)一步法检测 62例老年白血病患者bcr/abl融合基因的表达。　 结果 　 62例患者中bcr/abl融合基因阳性 5 3例 ,阳性率 85 5 % ,其中急性淋巴细胞白血病 (ALL) 17例 ,阳性 9例 (5 2 9% ) ;慢性粒细胞白血病 (CML)45例 ,阳性 44例 (97 88% )。DOCP方案治疗 7例bcr/abl+ ALL患者完全缓解 (CR)率 2 8 6% ,6例bcr/abl-ALL患者CR率 66 7% (P <0 0 1)。　 结论　bcr/abl融合基因检测有助于CML和ALL的临床诊断、治疗选择、微小残留病变 (MRD)监测以及预后判断 ;老年ALLbcr/abl融合基因阳性率较高 ,可能是其治疗效果较差的原因之一 ;bcr/abl+ ALL患者CR率明显低于bcr/abl-ALL患者 ;RT PCR一步法特异性好、敏感性高、简便快速 ,尤其适用于MRD的临床监测。更多还原

【Abstract】 Objective To study the expression and clinical significance of bcr/abl fusion gene in the elderly with leukemia. Methods bcr/abl fusion transcripts in 62 cases with leukemia was detected using the one-step reverse transcription polymerase chain reaction(RT-PCR). Results Fifty-three of 62 cases (85.5%) were found to be bcr/abl-positive.Among them,nine of 17 cases(52.9%)with ALL and forty-four of 45 cases(97.8%) with CML were positive.The complete remission(CR) rate is 28.6% in 7 cases with bcr/abl+ ALL and 66.7% in 6 cases with bcr/abl-ALL treated by DOCP regimen. Conclusions The detection of bcr/abl fusion gene is significant in clinic diagnosis,choice of treatment,monitoring minimal residual disease(MRD) and estimating prognosis in leukemia.The positive rate of bcr/abl fusion gene is high in older patients with ALL,which may be one of the causes of poor prognosis and less responsive to conventional chemotherapy.The outcome of the patients with bcr/abl+ ALL is bad and less responsive to chemotherapy than the patients with bcr/abl- ALL.The method of one-step RT-PCR is specific,sensitive,simple,rapid and exactly used to clinic detection of MRD.更多还原