论文部分内容阅读
目的观察甲磺酸伊马替尼(简称伊马替尼)治疗Ph+慢性粒细胞白血病(CML)患者骨髓bcr/ablmRNA水平的变化。方法采用实时定量(Realtimequantitative)RTPCR(RQPCR)技术连续监测34例α干扰素治疗无效Ph+CML患者在伊马替尼治疗前后不同时间120份骨髓标本bcr/ablmRNA水平。治疗前骨髓Ph+细胞百分率均≥95%。结果RQPCR的敏感度为10pgRNA,标准品日间差及日内差均<5%。10例伊马替尼治疗前标本中位bcr/ablmRNA水平为5.79%,各例之间差异甚大(0.24%～60.90%)。72份Ph+细胞百分率为0%～94%的治疗后标本bcr/ablmRNA水平与Ph+细胞百分率显著相关(r=0.82,P<0.001)。7例治疗12个月内达到完全遗传学缓解(CCyR)的患者bcr/ablmRNA水平随治疗时间延长而迅速降低,可供分析的6例患者治疗3个月时较治疗前下降65.9%～98.8%。达到CCyR后,bcr/ablmRNA水平随治疗时间延长继续下降,直至为0。4例治疗12个月后获得显著遗传学缓解患者(Ph+细胞百分率均<35%)bcr/ablmRNA水平缓慢下降,可供分析的3例患者治疗3个月时的bcr/ablmRNA水平分别比治疗前下降2.5%、18.5%及61.6%。5例持续遗传学无效,并且维持在慢性期的患者bcr/ablmRNA水平1例缓慢下降,2例缓慢上升,2例基本不变。4例治疗中发生急变的患者bcr/ablmRNA水平均逐步升高。结论对于伊马替尼
Objective To investigate the changes of bcr / abl mRNA in bone marrow of patients with Ph + chronic myeloid leukemia (CML) treated with imatinib mesylate. Methods The real-time quantitative RTPCR (RQCR) technique was used to continuously monitor the bcr / abl mRNA levels in 120 bone marrow samples of 34 IFN-α-treated Ph + CML patients before and after imatinib treatment. Before treatment, the percentage of bone marrow Ph + cells was> 95%. Results The sensitivity of RQPCR was 10 pgRNA, the difference between standard daytime difference and intraday difference was <5%. The median bcr / ablmRNA level in 10 cases of imatinib before treatment was 5.79%, with significant differences (0.24% -60.90%) among the cases. The percentage of bcr / abl mRNA in 72 samples with Ph + cell percentage of 0% ~ 94% was significantly correlated with the percentage of Ph + cells (r = 0.82, P <0.001). The level of bcr / abl mRNA in 7 patients who achieved complete genetic response (CCyR) within 12 months after treatment decreased rapidly with the prolongation of treatment time. The 6 patients for analysis decreased by 65.9% ~ 98.8% at 3 months after treatment, . After reaching CCyR, the level of bcr / abl mRNA continued to decrease with prolongation of treatment time until bcr / ablmRNA levels were slowly decreased for patients with significant genetic remission (Ph + cell percentage <35%) after 0.4 months of treatment for 12 months The level of bcr / abl mRNA in the 3 patients treated at 3 months after treatment decreased by 2.5%, 18.5% and 61.6% respectively compared with that before treatment. 5 cases of persistent genetic invalid, and maintained in patients with chronic phase bcr / ablmRNA level decreased slowly in one case, two cases increased slowly, two cases remained unchanged. The bcr / ablmRNA levels in 4 patients with acute changes were gradually increased. Conclusion For imatinib