儿童急性T淋巴细胞白血病微小残留病检测的临床意义

目的：探讨急性T淋巴细胞白血病（T-ALL）患儿微小残留病（MRD）监测的临床指导价值。方法采用多参数流式细胞术对2006年1月1日-2008年12月31日在北京儿童医院治疗的60例T-ALL患儿在治疗不同时间点进行追踪监测，分析不同MRD水平患儿的临床特征及预后。结果诱导治疗第33 d MRD≥1×10-4组患儿易复发，P＝0.03；诱导治疗第33 d MRD＜1×10-4组患儿预计5年无事件生存率（EFS）为100％，而MRD≥1×10-4组患儿5年EFS为（62.5±7.1）％，两组之间差异有显著性（P＝0.018）。结论监测T-ALL患儿MRD水平在评估早期治疗反应、监测复发以及估计预后中具有重要临床价值。

Clinical significance of minimal residual disease in childhood acute T-cell lymphoblastic leukemia

Objective To observe the Clinical significance of minimal residual disease （MRD）in childhood acute T-cell lymphoblastic leukemia （T-ALL）.Methods A total of 60 children with T-ALL were enrolled in this study from January 1of 2006 to December 31 of 2008.Their MRD levels were monitored by multiparameter flow cytometry in different therapy time point.The relationship between MRD levels and clinical features and prognosis were analyzed.Results The patients were divided into 2 groups according to the MRD level （MRD≥1 ×10 -4 or MRD 〈1 ×10 -4 ）at the early 33th day of induction therapy.The difference between these two groups was significant in the relapse （P=0.03 ） i.e.patients with MRD≥1 ×10 -4 were more likely to have relapse.The 5-year events-free survival was 100% in the patients with MRD〈1 ×10 -4 at the early 33 th day of induction therapy,and the 5-year events-free survival was 62.5% ±7.1% in the patients with MRD≥1 ×10 -4,there was significant between the two groups,P=0.018;the patients with MRD〈1 ×10 -4 had better prognosis.Conclusions Sequential monitoring MRD by multiparameter flow cytometry in different therapy time point should evaluate the early response and provide highly significant prognostic information in children with T-ALL.