PCR检测B-ALL IgH基因重排

为了探讨急性淋巴细胞白血病(ALL)患儿免疫球蛋白重链(IgH)基因重排的临床价值,应用多聚酶链反应(PCR)技术检测25例B-ALL患儿IgH基因。结果表明,25例中19例在初诊或复发时检出克隆性重排,并对此19例随访观察48次,平均随访时间为11.2月(2～25月)。IgH-PCR预测ALL复发率为58.8％,占复发病例的80％。阳性克隆检出时间先于形态学复发的平均时间为10.3周(1～28.8周)。本方法敏感性0.5％。该研究提示,IgH-PCR对监测 B-ALL的微量残留病(MRI)具有一定实用价值。但IgH-PCR阴性并不能排除即将复发,阳性可作为预测复发的信号。在随访的病例中,阳性者先后均复发。

Detection of Immunoglobulin Heavy Chain Gene Clonality in B-lineage Acute Lymphoblastic Leukemia by the Polymerase Chain Reaction

To investigate the clinical value for immunoglobulin heavy chain (IgH ) generearrangements in patients with Acute lymphoblastic leukemia (ALL), the method of polymerase chainreaction (PCR) for detection of IgH gene among 25 cases with B - ALL was applied. The result showedthat in 19 out of 25 cases the clonal rearrangements were confirmed at the initial diagnosis, or during thetime of relapse by IgH - PCR, and a consecutive followed - up was made, the total number being 48times. The mean followed - up time for the IgH - PCR positive patients was 11.2 months (range 2 to 25months). The predetection of ALL relapse rate by IgH - PCR was 58.8%, being 80% among the totalrelapse cases. The time of IgH - PCR clonality detection, preceeding the cytologic relapse, was 10.3weeks (range 1.0 to 28.8 weeks). The sensitivity of the approach was 0.5 %. We thought that IgH -PCR may be clinically useful for the detection of MRD of B - ALL. Nevertheless, a negative finding inthe patients by IgH - PCR does not rule put a forthcoming relapse, and a positive finding is a definitewarning signal. All of the followed - up patients may relapse sooner or later.