定量检测bcrabl mRNA在慢性粒细胞白血病患者异基因造血干细胞移植后的意义_医学论文.docVIP

定量检测bcr在慢性粒细胞白血病患者异基因造血干细胞移植后的意义_医学论文 定量检测bcr在慢性粒细胞白血病患者异基因造血干细胞移植后的意义_医学论文 作者：耿素霞，杜欣，翁建宇，李其辉，苏健华，林秋雄，李扬秋 【摘要】 本研究确切了解CML患者异基因造血干细胞移植后bcr的变化情况，为临床诊断早期复发提供实验依据。用实时荧光定量PCR方法检测15例慢性粒细胞白血病（CML）患者异基因造血干细胞移植前后78份外周血和骨髓标本的bcr水平。结果表明， 移植前患者的bcr水平较高，中位数为29.303％；移植后1个月时检测bcr水平较移植前大幅度降低，中位数为0；移植后1年内，连续多次检测bcr水平，变化模式不一致，但6个月后的总体水平较6个月前明显降低，移植1年以上的受者绝大多数bcr检测不到，或偶可检测到，但水平极低（0.007％、0.004%和0.021％），所检测受者的骨髓和外周血像均正常；同期骨髓与外周血bcr水平无明显差异，且变化趋势一致。结论：CML患者移植后早期bcr水平变化起伏较大，连续动态检测可明确其变化趋势，有助于判断移植效果、指导临床治疗，但6个月前检测到bcr存在并不提示疾病复发；检测外周血bcr或许更适于临床上对患者的随访。 【关键词】 慢性粒细胞白血病 Significance of Quantitative Detection of bcr Abstract The objective of this study was to analyze the level of bcrabl mRNA in peripheral blood (PB) after allogeneic stem cell transplantation (alloSCT) in chronic myeloid leukemia patients, providing a experimental basis for diagnosing early relapse. bcrabl mRNA levels in 78 PB and bone marrow (BM) samples from 15 CML patients after alloSCT were detected by using realtime quantitative PCR. The results indicated that levels of bcrabl mRNA before transplantation were high (median 29.303％) and decreased greatly (median 0) at the first month after allo or very low levels of bcrabl mRNA were monitored after 1 year following transplantation. The hematological features of BM and PB in all detected patients remained normal. PB and BM bcrabl values were not different significantly and had the similar trend of changes. It is concluded that the bcrabl mRNA levels in CML patients change greatly early after allograft. Serial monitoring measurements for bcrabl mRNA contribute to understanding the trend of change and effect of transplantation, also can be a guidance for starting therapy. But detectable levels of bcrabl mRNA during the first 6 months do not indicate relapse. Measurements of bcrabl mRNA of PB may be more suitable for routine monitoring longterm disease status in CML after alloHSCT. Key words chronic myelogenous leukemia bcrabl fusion gene realtime PCR minimal r