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目的 :探讨急性白血病微小残留病 (MRD)与化疗效应差异及受体基因重排 ,在急性非淋巴细胞白血病 (ANL L)中序列交叉现象及意义。方法 :应用聚合酶链反应技术对免疫球蛋白 (Ig H)及 T细胞受体 (TCR )基因重排进行定量测定。结果 :45例急性淋巴细胞白血病 (AL L)中阳性率 84.4% (38/ 45 ) ,完全缓解 (CR)后 180 d检测 ,阳性率仍 5 5 .6 % (2 5 / 45 ) ,2 0例 ANL L 中 5例检测到 Ig H受体基因重排 ,观察 6 0 d有复发迹象 ,但白细胞数持续 <1× 10 5 ,无复发。结论 :Ig H、TCR 基因重排是检测残留白血病的敏感指标 ,但在 ANL L中有失真现象。化疗效应的定量评价 ,有助于制定个体化的治疗方案。
Objective: To investigate the difference between acute residual leukemia (MRD) and chemotherapeutic effect and the gene rearrangement in acute leukemia and its significance in acute non-lymphocytic leukemia (ANL L). Methods: The immunoglobulin (Ig H) and T cell receptor (TCR) gene rearrangements were quantitatively determined by polymerase chain reaction (PCR). Results: The positive rate was 84.4% (38/45) in 45 cases of acute lymphoblastic leukemia and 180 days after complete remission (CR). The positive rate was still 55.6% (25/45), 20 IgR receptor gene rearrangements were detected in 5 cases of ANL L, and the signs of recurrence were observed on 60 days. However, the number of leukocytes continued to be less than 1 × 10 5, with no relapse. CONCLUSION: Ig H and TCR gene rearrangements are sensitive markers for the detection of residual leukemia, but are distorted in ANL L. Quantitative evaluation of the effect of chemotherapy, contribute to the development of individualized treatment options.