应用荧光原位杂交技术动态监测化疗与干细胞移植后白血病患者的染色体变化

背景：荧光原位杂交技术被广泛应用于白血病异常基因的检测中,但对于应用此项技术比较化疗与移植后疗效的研究尚未见大量报道。 目的：评价荧光原位杂交技术对化疗与移植后白血病患者的监测效果。 方法：新疆医科大学第一附属医院血液二科2009-10/2010-10收治的白血病患者44例,收集标本85份。按照各自采取的主要治疗方案,分为治疗前组,普通化疗组,特殊药物治疗组和造血干细胞移植组。特殊药物治疗组包括全反式维甲酸治疗和甲磺酸伊马替尼治疗患者。 结果与结论：荧光原位杂交技术在诊断与监测白血病微小残留病灶方面较染色体核型分析更为精确;荧光原位杂交结果显示特殊药物治疗组与造血干细胞移植组阳性细胞百分数均明显低于治疗前组和普通化疗组(P < 0.01),但特殊药物治疗组与造血干细胞移植组间差异无显著性意义(P> 0.05);急性移植物抗宿主病发生与移植后1个月荧光原位杂交结果不具有相关性(P > 0.05);移植后1个月、1~6个月、6个月以上荧光原位杂交检测结果差异无显著性意义(P > 0.05)。提示荧光原位杂交技术可以准确而有效的动态检测移植后患者的染色体变化情况,评价患者疾病发展趋势。

Dynamic fluorescence in situ hybridization monitoring for chromosomal changes in patients with leukemia after chemotherapy and stem cell transplantation

BACKGROUND:Fluorescence in situ hybridization (FISH) is widely used in the detection of abnormal genes in leukemia, but the application of this technique for comparing the efficacy of chemotherapy and transplantation has not been coverage a lot. OBJECTIVE:To evaluate the monitoring results of FISH in patients with leukemia after chemotherapy and hematopoietic stem cell transplantation. METHODS:A total of 85 specimens from 44 leukemia patients after chemotherapy or allogeneic stem cell transplantation were studied by FISH and conventional cytogenetic analysis. We divided the results into four groups: pretreatment group, chemotherapy group, special drug group (all-trans retinoic acid and imatinib mesylate) and hematopoietic stem cell transplantation group (transplantation group). RESULTS AND CONCLUSION:FISH in the diagnosis and monitoring of leukemia minimal residual diseases was more accurate than conventional cytogenetic analysis; The result of FISH showed that the percentage of positive cells in the special drug and transplantation groups was lower than that in the pretreatment and chemotherapy groups (P  < 0.01), but there was no difference between the special drug and transplantation groups (P  > 0.05). The incidence of acute graft-versus-host disease had no correlation with the results of FISH at 1 month after transplantation (P  > 0.05). The FISH results at 1 month, 1-6 months, over 6 months after transplantation had no difference in statistics (P > 0.05). FISH can detect of chromosomal changes for patients after transplantation accurately and effectively, and it can be used to evaluate the trends of disease progression in patients.