Ph染色体和bcr-abl融合基因的动态监测在慢性粒细胞白血病治疗中的临床意义

目的评价Ph染色体和bcr-abl融合基因检测在慢性粒细胞白血病诊断、治疗及微小残余病变监测中的临床意义。方法应用常规染色体显带技术、半定量反转录PCR(RT-PCR)技术和实时荧光定量PCR(RQ-PCR)技术对20例患者Ph染色体及bcr-abl融合基因进行动态监测,随诊3年。结果 20例慢性粒细胞白血病患者,19例患者Ph染色体阳性,20例均有bcr-abl融合基因阳性,其中11例应用伊马替尼治疗患者中9例患者Ph染色体和bcr-abl融合基因消失,提示遗传学缓解率为81.8%。9例应用常规化疗的患者随诊3年,Ph染色体和bcr-abl融合基因均未转阴。结论 Ph染色体和bcr-abl融合基因动态监测对慢性粒细胞白血病患者诊断、治疗、病情监测及预后判断有重要临床意义。

Clinical significance of dynamic monitoring of Ph chromosome and bcr-abl fusion gene in therapeutic course of chronic myeloid leukemia

Objective To evaluate the significance of detection of Ph chromosome and bcr - abl fusion gene expression in diagnosis, treat- ment and minimal residual disease monitoring in patients with chronic myeloid leukemia （CML）. Methods Karyotypes were analyzed by chromo- some G banding in 20 cases, and they were monitored with the level of bcr - abl fusion gene by RT - PCR and RQ - PCR for 3 years. Results All 20 patients had positive bcr- abl fusion gene, 19 of them had ph chromosome. Among 11 patients treated with imatinib, ph chromosome and bcr - abl fusion gene had been turned to negative in 9 cases. The cytogenetic response rate was 81.8%. Remaining 9 patients were treated with traditional chemotherapy, followed up for 3 years, none of them had ph chromosome and bcr - abl fusion gene turned to negative. Conclusion Analysis of chromosome karyotypes and detection of bcr - abl fusion gene have important clinical significance in diagnosis, treatment, outcome mo- nitoring and prediction of prognosis of CML.