微小残留病灶检测判断急性淋巴细胞白血病预后临床研究.docVIP

微小残留病灶检测判断急性淋巴细胞白血病预后临床研究 　　【摘要】 目的：探讨微小残留病灶（MRD）检测对急性淋巴细胞白血病（ALL）预后判断的临床价值。方法：选取本院收治的120例ALL患者作为研究对象，于诱导缓解治疗第33天、维持治疗第3个月分别对患者进行骨髓MRD检测，统计MRD阳性及阴性患者不同危险度及不同治疗时期的复发情况，同时比较诱导缓解治疗第33天不同骨髓缓解状况下MRD水平。结果：诱导缓解治疗第33天以及维持治疗第3个月，高危组的MRD阳性率均显著高于中危组及低危组，差异有统计学意义（P0.01）；不同治疗时期MRD阳性复发率显著高于MRD阴性复发率，差异有统计学意义（P0.05）；诱导缓解治疗第33天骨髓象达M1的患者MRD≥10-2比例显著低于M2与M3组，差异有统计学意义（P0.01）；诱导缓解治疗第33天骨髓象达M1患者的复发率显著低于M2与M3组，差异有统计学意义（P0.01）。结论：MRD水平与ALL的预后有关，MRD阳性可作为ALL患者预后判断的重要因素。 　　【关键词】 微小残留病灶； 急性淋巴细胞白血病； 预后； 复发 　　【Abstract】 Objective：To investigate the clinical value of the detection of minimal residual disease （MRD） in the prognosis of acute lymphoblastic leukemia （ALL）. Method：120 patients with ALL were selected as the research objects，they were treated in the induction of remission in thirty-third days and maintenance therapy in the third months with bone marrow MRD detection， the MRD positive and negative patients with different risk and treatment period of relapse were compared. At the same time，the different bone marrow MRD levels of the induction of remission in thirty-third days were compared.Result：The induction of remission in the treatment of the thirty-third days and maintenance therapy in the third months， MRD positive rate of high risk group was significantly higher than that in middle risk group and low-risk group， the differences were statistically significant（P0.01）；different treatment period MRD positive recurrence rate was significantly higher than that of MRD negative recurrence rate，the difference was statistically significant （P0.05）； remission induction therapy with the thirty-third days bone marrow of M1 with minimal residual disease （MRD）≥10-2 was significantly lower than that of M2 and M3 group，the difference was statistically significant（P0.01）； remission induction in the treatment of the thirty-third days bone marrow of M1 recurrence rate was significantly lower than that of M2 and M3 group，the difference was statistically significant（P0.01）. Conclusion： MRD level is