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中枢神经系统白血病(CNSL)是影响小儿白血病长期生存的重要原因之一。但是在CNSL的早期,脑脊液中的白血病细胞数量很少不易被查到或经化疗后白血病细胞形态发生改变致分辨困难,使得常规脑脊液化验不能敏感地、特异性地检测出微量白血病细胞。我们采用PCR技术在体外扩增白血病细胞IgHCDR-和TCRr基因重排序列,可以敏感地、特异性地检测到急性淋巴细胞白血病(ALL)患儿脑脊液中微量白血病细胞。共检测108份脑脊液标本(来自38例ALL患儿),其中IgHCDR-阳性24份(14例ALL患者儿),其中3份脑脊液标本同时伴TCRr阳性。有4例ALL患儿先于常规检测出现阳性结果,有8例与常规检测同时出现阳性结果,另2例只有PCR阳性给以CNSL预防治疗后PCR阴转
Central nervous system leukemia (CNSL) is one of the important reasons that affect the long-term survival of childhood leukemia. However, in the early stage of CNSL, the number of leukemic cells in cerebrospinal fluid is seldom found easily or the differentiation of leukemia cells after chemotherapy is difficult to distinguish. Therefore, routine cerebrospinal fluid tests can not sensitively and specifically detect leukemic cells. We amplified the leukemia cell IgHCDR- and TCRr gene rearrangement sequences by PCR in vitro, and detected the microleukemic cells in cerebrospinal fluid of children with acute lymphoblastic leukemia (ALL) sensitively and specifically. A total of 108 cerebrospinal fluid samples (from 38 ALL patients) were detected, of which 24 were IgHCDR-positive (14 ALL patients). Three of the cerebrospinal fluid samples were also positive for TCRr. There were 4 cases of ALL children with positive results before routine testing, 8 cases with positive results simultaneously with routine testing, and the other 2 cases with PCR-positive only after PCR-positive for CNSL prophylaxis