T细胞受体双基因标志检测对ALL患儿化疗效应评价初探

目的

Dynamic quantitative evaluation of the difference of chemotherapy efficiency in children acute leukemia

Objective To investigate the dynamic quantitative evaluation of the difference of the chemotherapy efficiency in children acute lymphoblastic leukemia(ALL) and its significance. Methods We had established the DNA quantitative methods of competitive polymerase chain reaction(CPCR) of T cell receptor(TCR) δ and γdouble gene. The minimal residual disease(MRD) was detected and the therapy efficiency evaluated quantitatively in children ALL. TCRδ gene rearrangement was detected in acute myelocytic leukemia(AML) and contrast with ALL. Results ①The frequency of TCRδ,γ gene rearrangement were respectively 81% and 76% in 96 ALL, with the detecting technique of TCR δ and γ double gene, the frequency was 88.5%. The frequency of TCR δ gene rearrangement had significant difference between the cases at B-ALL(86%) and T-ALL(25%) (calculate exact probabilities, P=0.016). ②TCR γgene rearrangement were 54% in AML-M5, it showed AML-M5 had the co-originate of gene rearrangement with ALL and may originate from the common progenitors of early myeloid and lymphoid cells. ③One hundreds and thirty-two samples were detected quantitatively and the efficiency were evaluated dynamically at remission in 66 ALL children. It showed the inducting therapy efficiency was related closely to the amount of MRD and prognosis at early inducting remission phase. The cases had higher level of MRD and comparatively lower chemotherapy efficiency at CR of 4～12 months, the rate of clinical relapse was higher than other phase. Conclusion The technique of CPCR-DNA quantitative of TCR δ and γdouble gene can cover more ALL gene rearrangement and increase the sensitivity of detecting MRD. It may evaluate effectively the therapy efficiency of a larger sampies of ALL and is helpful for individualized treatment.