实时定量PCR监测多发性骨髓瘤患者自体造血干细胞移植后微小残留病

为了探讨应用实时定量PCR方法在监测多发性骨髓瘤患者造血干细胞移植后微小残留病 (minimalresid ualdisease ,MRD)中的作用 ,利用SYBRGreenⅠ荧光染料 ,采用实时定量PCR方法 ,以IgH为标志 ,对 8例多发性骨髓瘤和 1例Waldenstr m巨球蛋白血症患者自体外周血干细胞移植 (autologousperipheralbloodstemcelltrans plantation ,APBSCT)前后的IgH(immunoglobulinheavychain ,IgH)基因重排进行定量分析。结果发现 ,IgH基因重排拷贝数在APBSCT前后分别为 3 10 8± 10 43 ,594± 660 ,两者差异有显著性 (P <0 .0 5) ,与患者骨髓浆细胞比值和外周血M蛋白量成正相关 (r =0 .86,P <0 .0 5) ,并对 1例复发患者进行连续检测 ,结果与临床相符。结论 :实时定量PCR方法对IgH基因重排定量分析 ,可以作为判断多发性骨髓瘤治疗疗效的一种检测方法 ,并对患者的预后判断也有意义

Real-time Quantitative PCR Detecting Minimal Residual Disease in Multiple Myeloma Patients after Autologous Peripheral Blood Stem Cell Transplantation

In order to explore the role of real-time PCR in detecting minimal residual disease in multiple myeloma and Waldenstrom's macroglobulinemia after autologous peripheral blood stem cell transplantation (APBSCT), real-time PCR was used to quantitate the IgH rearrangement in 8 patients with multiple myeloma (MM) and 1 case of Waldenstrom's macroglobulinemia before and after APBSCT. The results showed that the copies of IgH rearrangement pre- or post-APBSCT were 3108 +/- 1043 and 549 +/- 660 (P < 0.05) respectively. The number of IgH copies was positively correlated with the amount of plasmocytes in patient 's bone marrow and the M-protein in peripheral blood (r = 0.86, P < 0.05). Similar result was obtained in a case of relapsed Waldenstrom's macroglobulinemia. In conclusion, the quantitative analysis of IgH rearrangement by real-time PCR is a novel way to evaluate the therapeutic efficaciousness and predict the prognoses in MM patients.