【摘要】 背景与目的:监测慢性髓系白血病(chronic myeloid leukemia,CML)的微小残留病(minimal residual disease,MRD)的常用方法有间期荧光原位杂交(interphase fluorescence in situ hybridization,FISH)和实时定量逆转录-聚合酶链反应(real-time quantitative reverse transcription PCR,RQ-PCR)。本研究分析用FISH和RQ-PCR两种方法在CML造血干细胞移植后不同时间点监测MRD的意义。方法:采用间期FISH和RQ-PCR技术,对31例异基因造血干细胞移植前后的CML患者骨髓细胞进行BCR-ABL融合基因定期监测,随访时间3～48个月。结果:31例患者移植后,前30个月各时间点FISH检测的阳性细胞数及RQ-PCR检测的BCR-ABL/ABL比值均较移植前明显下降,下降>2个对数值(P<0.05);移植30个月后FISH检测结果为0时,RQ-PCR仍然能检测出BCR-ABL/ABL的表达水平,与移植前相比,30个月后各时间点BCR-ABL/ABL比值下降>3个对数值(P<0.05)。结论:FISH和RQ-PCR方法检测BCR-ABL融合基因有较好的一致性。RQ-PCR连续监测MRD的敏感性更高,MDR的定量分析有利于评估疗效和指导个体化治疗。更多还原

【Abstract】 Background and Objective:Interphase fluorescence in situ hybridization (FISH) and real-time quantitative reverse transcription PCR (RQ-PCR) are the common methods for monitoring minimal residual disease (MRD) in chronic myeloid leukemia (CML) patients.This study was to assess the value of monitoring BCR-ABL fusion gene level in CML patients after allogeneic hematopoietic stem cell transplantation (allo-HSCT) using FISH and RQ-PCR.Methods:BCR-ABL fusion gene levels were detected in the bone marrow of 31 patients with CML before and 3-48 months after alloHSCT using FISH and RQ-PCR.Results:BCR-ABL positive cells detected by FISH were decreased 3-30 months after allo-HSCT and BCR-ABL /ABL mRNA was reduced by 2 logarithmic units in RQ-PCR (P < 0.05).While no BCR-ABL positive cell was detected by FISH 30 months after allo-HSCT,BCR-ABL /ABL mRNA was detected by RQ-PCR and declined by more than 3 logarithmic units (P<0.05).Conclusions:Dynamic monitoring of BCR-ABL gene on molecular level in CML patients after allo-HSCT is useful in the early prediction of susceptibility to recurrence in the patients and in designing intervention,and is thus helpful in improving the overall survival rate after transplantation.更多还原