摘要
目的:探讨流式细胞术在儿童急性B淋巴细胞白血病(B-lineage acute lymphoblastic leukemia,B-ALL)患者化疗全程检测微小残留病(minimal residual disease,MRD),观察其在预测复发中的意义。方法:采用四色多参数流式细胞术对我中心291例B-ALL患儿在化疗第19天、第35天、第55天(中高危组)、第14～17周、第28～36周、第52～54周、第78～83周、第102～107周、停药及停药后分别进行MRD检测。结果:①291例患儿中MRD<0.01%、0.01%～0.1%、0.1%～1%和>1%分别有169例、35例、44例和43例,其7年累计复发率分别为4.1%、17.1%、29.5%和62.8%。4组复发率差异有统计学意义(P﹤0.0001)。②各时间点MRD阳性组复发率均高于MRD阴性组,差异均有统计学意义(第19天,P=0.0021;第55天,P=0.0008;停药后,P=0.0025,余P均<0.0001)。③第35天MRD阳性在早期复发和晚期复发患儿中均常见;14～17周MRD阳性对预测早期复发意义较大;停药后MRD阳性对预测晚期复发意义较大。结论:采用流式细胞术检测MRD阳性情况在一定程度上可预测白血病复发。各时间点MRD阳性与复发均有一定相关性,且预测复发的意义不同。
Objective To study the value of detection of minimal residual disease（MRD） by flow cytometry（FCM） during the process of chemotherapy for predicting relapse in childhood B-lingeage acute lymphoblastic leukemia.Methods MRD was detected by four-color flow cytometry on day 19,day 35,day 55（only for medium-or high-risk group） and week 13-17,week 28-36,week 52-54,week 78-83,week 102-107,last day of the chemotherapy process and during follow-up in 291 childhood B-lingeage acute lymphoblastic leukemia patients.Results ① MRD were 〈0.01%,0.01%-0.1%,0.1%-1%and 〉1% in 169,35,44,43 patients,respectively.The 7 years cumulative incidence of relapse were 4.1%,17.1%,29.5% and 62.8% in patients with MRD〈0.01%,0.01%-0.1%,0.1%-1%and 〉1%,respectively.The differences between these four groups were statistically significant（P〈0.0001）.② The difference in relapse rate was statistically significant between MRD positive and MRD negative patients at every detection time point.（P=0.0021 on day 19,P=0.0008 on day 55,P=0.0025 during follow-up,and other time points P〈0.0001） ③ Day 35 was an important time point to predict early and late relapse,week 14-17 was an important time point to predict early relapse,and MRD positive during follow-up was valuable for predicting late relapse.Conclusions MRD detection by flow cytometry is valuable for predicting relapse of childhood B-ALL and has different significance at different time points.
出处
《诊断学理论与实践》
2012年第2期141-144,共4页
Journal of Diagnostics Concepts & Practice
关键词
急性B淋巴细胞白血病
微小残留病
流式细胞术
复发
儿童
B-lineage acute lymphoblastic leukemia； Minimal residual disease； Flow cytomety； Relapse； Children
