论文部分内容阅读
急性白血病完全缓解(CR)后体内仍残存10~6～10~8个白血病细胞。将CR状态下还存在微量的白血病细胞称为微小残留病(MRD),MRD必然是白血病复发的原因,因此早期诊断MRD可预防其复发。本文阐述MRD的检测方法的敏感性、技术问题及实用性。一、培养法在急性白血病CR状态检测残留微量白血病细胞集落形成,其集落必须证实是白血病细胞的集落,即需要有细胞表面标记或染色体分析。ALL根据培养法细胞表面标记确认为白血病细胞较易,AML白血病细胞分化等引起抗原变化,表面标记难以利用,AML的白血病细胞集落形成难,用培养法检测AML的MRD未成功。有人用培养法从13例小儿ALL中检出6例白血病细胞集落(55～190/2×10~5个),集落形成率50％,去除T-细胞的骨髓细胞的白血病细胞混入率0.025～0.1％,诊断为MRD的病例几乎
After complete remission of acute leukemia (CR), 10 to 6 to 10 to 8 leukemia cells remain in the body. The existence of microscopic leukemia cells in the CR state is called minimal residual disease (MRD), and MRD is necessarily the cause of relapse of leukemia, so early diagnosis of MRD can prevent its recurrence. This article describes the sensitivity, technical issues, and practicality of MRD assays. First, the culture method detects the residual micro leukemia cell colony formation in the CR status of acute leukemia. The colony must be confirmed to be a colony of leukemia cells, ie, a cell surface marker or chromosome analysis is required. According to the culture method, cell surface markers were identified as leukemia cells, AML leukemia cell differentiation caused antigen changes, surface markers were difficult to use, and AML leukemia cell colonies were difficult to form. Detection of AML MRD by culture method was unsuccessful. Some 6 cases of leukemia cell colonies (55 to 190/2 x 10 to 5) were detected by culture from 13 children with ALL. The colony formation rate was 50%. The leukemia cell admixture rate of T-cell myeloid cells was 0.025 to 0.1% of cases diagnosed with MRD are almost