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目的 将间期荧光原位杂交 (FISH)技术应用于慢性粒细胞白血病 (CGL)移植后疗效判断及体内残留Ph阳性细胞的检测。方法 应用FISH、细胞遗传学技术、RT PCR技术对 10名正常人、7例未治疗CGL患者和 11例移植后CGL患者体内Ph阳性细胞进行检测。结果 对 11例CGL患者移植后 1周～ 6年不同时间的 40个样本的实验研究发现 :①移植后 1个月内FISH及RT PCR技术较之常规染色体检查更易检测出Ph阳性的样本 ,但 6个月后RT PCR更敏感 ;②残留Ph阳性细胞随移植后时间延长呈线性递减 ,转阴的中位时间为移植后第 5 7天 (2 2～ 170天 ) ;③ 1例复发患者移植后 1个月Ph阳性残留细胞为 33.6 5 % ,半年后复发 ,而染色体检查于移植后 6个月方发现异常 ,RT PCR检测结果持续阳性 ,无法观测其变化。结论 间期FISH检测比染色体核型、RT PCR更能准确地评价移植后体内残留的白血病细胞的负荷量 ;采用FISH法动态观察残留白血病细胞的变化 ,可以判断疗效 ,发现早期复发 ,及时进行干预性治疗。
Objective To evaluate the efficacy of interphase fluorescence in situ hybridization (FISH) in the detection of residual Ph positive cells in chronic myelogenous leukemia (CGL) transplantation. Methods Ph positive cells in 10 normal subjects, 7 untreated CGL patients and 11 CGL patients after transplantation were detected by FISH, cytogenetics and RT-PCR. Results The experimental study of 40 samples of 11 CGL patients from 1 week to 6 years after transplantation showed that: ①FISH and RT PCR techniques within 1 month after transplantation were more likely to detect Ph positive samples than conventional chromosomal tests, but RT PCR was more sensitive after 6 months; ② The residual Ph positive cells decreased linearly with time prolonged after transplantation, the median time of negative conversion was 57 days after transplantation (2 2 ~ 170 days); ③ One case of recurrent patients After 1 month, the number of Ph-positive cells was 33.6 5%, and relapsed after 6 months. Chromosome examination showed abnormalities at 6 months after transplantation, and the results of RT-PCR were consistently positive and could not be observed. Conclusion Interphase FISH is more accurate than chromosomal karyotyping and RT-PCR in evaluating the residual leukemia cell load in vivo. FISH can be used to observe the changes of residual leukemia cells in order to detect the early recurrence and prompt intervention Sexual treatment.