儿童急性白血病mdrl,bcl-x_L/bcl-XS和bcl-2/bax基因表达水平改变及其临床意义

目的　 通过检测儿童急性白血病多药耐药基因及细胞凋亡调控基因表达水平的改变 ,分析不同类型白血病的主要耐药机制。 方法 　采用RT PCR检测 75例儿童急性白血病骨髓细胞mdr1、Bcl 2、Bax、bcl xL 和Bcl xs基因的mRNA表达水平 ,同时分析化疗效果。结果 　ANLL耐药组mdrl基因和bcl 2基因表达率明显升高。其中7/14例mdrl阳性表达的未缓解患者同时具有Bcl 2基因的表达 ;ALL耐药组中Bcl 2 /Bax和bcl xL/bcl XS的比值升高明显高于药物敏感组。结论 　儿童ALL和ANLL存在不同的耐药机制。

The expression of mdrl,bcl-xL/bcl-xs and bcl-2/bax genes and its significance in the clinical treatment

Objective To study the drug resistance in different types of acute leukemia in children, the expression of multidrug resistance gene and apoptosis-related genes were analyzed. Methods the expression of the mRNA of the mdrl, bcl-2, Bax, bcl-x L and Bcl-xs genes were detected from the bone marrow cells of 75 patients with acute leukemia by RT-PCR. Results In the group of drug resistant ANLL, the positive rate of expression of mdrl and bcl-2 genes were increased statistically. There were 7/14 patients with mdrl positive had bcl-2 gene expression; The increased ratio of bcl-2/bax and bcl-x L/bcl-xs was more happened in drug resistant patients than in drug sensitive patients in the group of ALL. Conclusion There are different drug resistance mechanism in the children with acute leukemia.