多重实时荧光定量PCR法筛查成人Ph样急性淋巴细胞白血病
Screening of adult Ph-like acute lymphoblastic leukemia by multiplex real-time quantitative PCR
目的 探讨多重实时荧光定量PCR法早期、快速筛查Ph样急性淋巴细胞白血病(ALL)的可行性,了解Ph样ALL的临床特征及预后.方法 2010年10月至2016年3月收治的118例初诊成人B-ALL患者纳入研究,利用多重实时荧光定量PCR法检测其中58例BCR-ABL融合基因和MLL重排均阴性患者Ph样相关融合基因及细胞因子受体样因子2(CRLF2)表达情况.比较分析Ph样融合基因阳性和(或)CRLF2高表达患者的临床特征、疗效和预后.结果 检出Ph样融合基因阳性患者9例(9/58,15.5%),CRLF2高表达患者10例(10/58,17.2%). Ph样融合基因阳性和(或)CRLF2高表达组、Ph阳性组、MLL重排阳性组以及其他患者组在年龄、WBC、免疫分型、细胞遗传学、危险度分组方面差异有统计学意义(P值均< 0.01).四组患者的2年总生存率分别为65%、47%、64%、74%(P=0.043),2年无复发生存率分别为51%、39%、62%、70%(P=0.010).结论 采用多重实时荧光定量PCR法筛查Ph样ALL患者可行,Ph样ALL患者预后较差.
更多Objective To investigate the feasibility of multiplex real-time RT-PCR with fluorescent probes in early screening of Ph-like acute lymphoblastic leukemia (ALL) and analyze the clinical feature and prognos.Method A total of 118 adult B-ALL patients diagnosed between October 2010 and March 2016 were enrolled in this study.Multiplex RT-PCR was used to detect the Ph-like ALL related fusion gene and CRLF2 expression in 58 BCR-ABL and MLL rearrangement negative patients.The clinical features,treatment response and prognosis were analyzed in Ph-like fusion gene positive and/or CRLF2 over-expression patients.Result Among 58 patients,9 patients (9/58,15.5%) showed Ph-like ALL related fusion genes positive and l0 patients (10/58,17.2%) showed CRLF2 over-expression.There were statistical differences in age,WBC count,immunophenotypes,cytogenetics and risk stratification among Ph-like fusion gene positive or CRLF2 over-expression patients,Ph+ patients,MLL+ patients and Bother patients.The 2-year overall survival rates were 65%,47%,64% and 74% respectively among these four groups (P =0.043).The 2-year relapse free survival rates were 51%,39%,62% and 70% respectively among these four groups (P =0.010).Conclusion Routine screening of Ph-like ALL by multiplex RT-PCR is feasible.
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