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目的 探讨儿童急性淋巴细胞性白血病 (ALL)中 ,微小残留白血病 (MRL)与mdr 1基因表达动态监测的临床意义。方法 对 35例ALL患儿不同病期骨髓标本进行PCR或巢式PCR检测IgH和TCRVδ2 Dδ3 基因重排 ,同时应用半定量RT PCR检测mdr 1基因表达。结果 随着完全缓解期延续 ,IgH或 /和Vδ2 Dδ3 基因重排检出率逐渐下降 ,而mdr 1基因阳性表达检出率增加 ,IgH或 /和Vδ2 Dδ3 基因重排持续检测阳性或mdr 1表达水平增高者易复发。结论 动态监测MRL和mdr 1基因表达可判断疗效和预知复发 ,且较一次单独检测更为重要。当IgH或 /和Vδ2 Dδ3 转阴后检测mdr 1基因表达可作为预知复发的一个辅助指标
Objective To investigate the clinical significance of dynamic monitoring of MRL and mdr 1 gene expression in children with acute lymphoblastic leukemia (ALL). Methods 35 cases of ALL children with different stages of bone marrow specimens PCR or nested PCR detection of IgH and TCRVδ2 Dδ3 gene rearrangement at the same time using semi-quantitative RT PCR detection of mdr 1 gene expression. Results With the continuation of complete remission, the detection rate of IgH or / and Vδ2 Dδ3 gene rearrangement gradually decreased while the positive rate of mdr 1 gene expression increased. IgH or / and Vδ2 Dδ3 gene rearrangement continued to be detected or mdr 1 was detected Those who are prone to recurrence of higher levels. Conclusion Dynamic monitoring of MRL and mdr 1 gene expression can determine the efficacy and predict the recurrence, and more important than a single test. Detection of mdr 1 gene expression after negative IgH or / and Vδ2 Dδ3 conversion may serve as an adjunct to predict relapse